As the healthcare debate picks up pace, I find myself being asked with increasing regularity what I think of Britain’s healthcare system. Six months ago, I’d have jumped into the answer with gusto, but these days… I don’t know, I am just so fatigued by all the fear-mongering and hysteria, the ignorance and the downright idiocy of the current debate that I can hardly summon the energy to add my voice to the cacophony.
But the other night when a friend of my mother’s emailed me and asked that now-familiar question — what was my experience and what did I think of British health care? — and I was surprised to discover that, once the initial weariness had worn off, I found myself turning her question over and over in my mind, composing my answer. When I sat down last night and started my reply, the words fell out me, my fingers tapping rapidly at the keyboard and my mind so engrossed in the assignment that I was stunned when I finally looked at the clock: it was 2.30 in the morning. I had been so consumed because what I had to say had been bursting to come out, an outraged truth that was tired of being bottled-up and was begging to be told.
When I lived in the UK, I railed against the NHS (the National Health Service). I cursed every delay, every perceived inconvenience, every way it differed from the care I had received in the US. But I moved to the UK only a few months after graduating from university and, until then, I had been covered on my parents’ very generous insurance so I had experienced American healthcare only as a dependent. I was judging my British experience from a lofty and privileged position of someone who’d always had gold-plated insurance. And I was naive, because I’d never had to pay for it, never had to worry it wouldn’t be there, never really had to deal with the paperwork. I never really understood what I was comparing the NHS to at all.
I also realise with hindsight that a lot of what I held against the NHS had nothing to do with the system itself and actually were issues that could happen in any system. I blamed the whole system when the loo in my local doctor’s office or hospital wasn’t clean enough. I blamed the whole system when the only space I could find at the hospital carpark was miles away in the very furthest corner. I blamed the whole system when the doctors’ receptionist was grumpy or I didn’t much like my doctor’s manner (or his diagnosis). But the truth was that I believed in the healthcare system I had grown up in and I didn’t like the idea of socialised medicine — I didn’t like socialised anything — so I saw problems with it where-ever I chose to look. And I held onto that belief right up until I arrived back in the United States, and discovered that grumpy receptionists and dirty hospital bathrooms and annoying carparks can happen in any system — because they have nothing to do with the system itself. They’re management issues, human nature issues, and they happen everywhere. And a lot of the fear that Americans have about change in their healthcare actually center around these kind of issues that have nothing to do with the system itself, be it socialised or for-profit.
So my return to the US and my sudden immersion in the American healthcare system was a rude awakening for me and it made me look at both systems a little more realistically. There are great things about healthcare in the US — great things — and I truly do believe that the quality of the care here is second to none. But there are great things to be said about Britain’s system as well and the trouble is that, at present, far too few people are saying those great things and far too many here in the US are beginning to believe utterly ridiculous things about the NHS. Let me play a small part in putting that right by outlining my experience of the British healthcare system.
- First, I’ll start by pointing out that the NHS is truly one of the most socialist — almost Soviet — healthcare models that a country could possible choose. Unlike the health systems in France, Germany, and most of the rest of the developed world, it is totally government-run, almost totally centrally-controlled, and supported entirely through taxation. It is mammoth — the single largest employer in Europe, which is incredible when you realise it serves a small country with only 60million people. And with that kind of size come huge problems — consultation times are too short and it takes too long to get test results, amongst other things. It is not a perfect system by any stretch of the imagination. But it’s important to realise that when I talk about my experience, I am talking about the kind of system that truly is the very far extreme of what the nay-sayers are claiming will be the end result of public health provision in the US. The British system is the very stuff of their nightmares and yet, the truth is, it’s nothing like what they imagine.
- My healthcare in the UK was never dictated by a bureaucrat. Decisions were made by me and my doctor alone, and whatever we decided was the right course of action was the course that was taken. The scope of care available to me was far, far wider than what is covered even by the ‘very good’ insurance policies I’ve had here in the US. There were no limits on the number of times I could see my doctor, or the number of tests/procedures/consultations/etc that I could have in a year (or month or lifetime…) Whatever was deemed medically necessary by my doctor was covered — period. In fact, I’ve experienced a lot more limitations on my care since I’ve moved back to the US — the most memorable of which was when I had to beg the insurance company to cover a single visit to a nutritionist when E2 was diagnosed with 12 food allergies and was severely underweight. That simply never would have happened in the UK — if she needed it (and she did), she’d have got it (as her sister did after being diagnosed with a single allergy). To illustrate the point further, when I gave birth to E1, I stayed in hospital for five days because she had problems with breastfeeding — and that was entirely my decision. I was free to leave hospital whenever I wanted, be that after one day or after a week, and I had the full support of the midwives to stay until they were sure we were breastfeeding properly and ready to leave — no administrator/bureaucrat/insurance company made that decision for me!
- There are delays — there are delays — but to be honest I have experienced delays just as bad here in the US. In the UK, I might have to wait weeks or months to see a specialist if my case was not urgent, and that was frustrating. Here in the US, when I was in excruciating pain last year (so bad that I lost control of my bodily functions when the pain hit), I was referred to a breast surgeon by the ER doctor (7 hour wait in ER) — but the trouble is that we had to call five medical centers before we could find a surgeon who could see me any sooner six weeks, and even then it was only because they had a surprise cancellation. And the last time I needed to take E2 to the allergist here in the US, the earliest they could fit me in was two months later. There are delays in both systems. And by contrast, you can get very speedy service in the US… and you can get it in the UK too. When I needed to see my GP in the UK, I rarely had to wait until even the next day. When I thought I’d found a lump in my breast, I saw the doctor the next day and was sent to a specialist within the week.
- I had my choice of doctors. My small rural town had two GP offices (a GP is a General Practitioner, a family doctor) with about 5 GPs in each office — I could choose either office and any GP in that office I chose. I could choose to go to the GPs office in a neighbouring town if I prefered (though some offices limit the regional area they’ll cover). I could change GPs at anytime for any reason, no questions asked. When I had my babies, I had my choice of any of the hospitals in the region, or a homebirth (the midwives in my area loved doing homebirths!). When my GP referred me to a specialist, he’d send me to whomever he thought best, but if I wanted someone or somewhere else, I could request that, no problem. And I always had the option of a second opinion, either through another NHS doctor or a private doctor.
- I never once received a bill in the UK. There are no copays, there are no deductibles, there is no such thing as max-out-of-pocket. I have an NHS card which I showed at my GP’s office when I registered, and from that point on, I never had to fill out any forms or show any ID ever again. In fact, I think I lost my NHS card years ago — I have no idea where it is. It doesn’t matter — I don’t need because I am covered for everything once I am registered with my GP. When I stepped on a piece of glass and sliced up my foot, I went up to the local hospital, was seen immediately (rural hospital on a Tuesday afternoon), they took note of my name and address, patched me up, and I went home — simple as that. No bills, no paperwork, no hassle. Yes, Brits pay to cover it in their taxes, but the cost spread across the entire country and so it isn’t nearly the burden that insurance is for Americans. In fact, Brits spend only 8.4% of GDP on healthcare, compared to the 16% of GDP spent by Americans and what they get back is a system beats the US on so many basic measures of healthcare results. This is good quality care.
- Brits believe that healthcare is a human right and are happy to have a system that covers everyone, all the time. They are HORRIFIED when they hear stories of Americans who have to hold fundraisers to pay for desperately-needed operations. It blows their minds that anyone goes bankrupt or loses their home because of medical bills. The idea that someone would lose their coverage because of a pre-existing condition or because they are so sick they can’t work is totally alien to them. These things simply do not happen in Britain.
- Even with a comprehensive healthcare system that is available to all and completely free (at the point of delivery) the UK still has a healthy private system running alongside the state system. There are numerous large private insurance companies providing private health insurance to those who’d like to have it (or whose companies want to offer it). There are private hospitals up and down the country. Most specialists practice both within the NHS and also privately (they split their weeks). You can pretty much get your healthcare however you’d like — on the NHS, through private insurance, or paid out of your own pocket. I hear people in the US saying that with in the British system, you can’t see anyone but your government-assigned doctor, but that is totally untrue. And you can chop and change your care as it fits your life — I’ve had my care for an medical issue start on the NHS, and then switched my care to my private insurance if it suited my needs better. I’ve had other medical issues that I stayed with the NHS for the whole way. And when my husband had an elective medical procedure done that was covered by neither the NHS nor insurance, we simply paid for it out of pocket. It’s a flexible system and the private sector has not been quashed by the fact that there is a comprehensive, free public system running alongside it.
- Because healthcare is not tied to employment, companies are free to focus on their core business and people are free to make career decisions (and life decisions) based on what is best for them instead of what preserves their healthcare. Brits never worry about keeping their healthcover — they never worry about pre-existing conditions; they never worry about continuity of care if they change jobs; they never get trapped into a bad-fit job because they have to keep their healthcover. They are much freer to be entreprenuers than Americans, because their only worry is whether their business will succeed, not how they’re going to provide healthcover for their families when they’re self-employed. Companies, particularly small companies, are free to focus on their core-business because they not burdened by the administration of healthcare for their employees — they never have to pay someone in HR to manage health benefits; they don’t have to juggle insurance companies and negotiate lower premiums; they don’t lose employees because their healthplan isn’t as good as some other company; they don’t see their bottom line rocked by a sudden rise in premiums. Decoupling healthcare from employment is hugely freeing to both individuals and employers, and can actually a very good thing for the economy at large.
- When things go wrong, the government answers to the people in a way that insurance companies never do. For example, there was a cancer drug called Herceptin which was not covered on the NHS because of the cost. A group (led by Ann Marie Rogers) began a campaign to change this, suing their local health trust, and gained huge public support. They ultimately won their case and got their local trust to offer the drug — but because of the political pressure this campaign had created, the government extended the drug to the entire country. Imagine trying to convince an American insurance company to cover some expensive drug that they don’t want to cover, and then having that decision convince every other insurance company to do the same. And again, when I moved to the UK fifteen years ago, wait times in the NHS were much worse than they are now — but the public got fed up with it, made their voices heard in the General Election, and the new administration made cleaning up the NHS one of their highest priorities.
- There is an emphasis on preventative care and the simplest way this happens is that people actually go to see their doctor when they are sick. Because there’s no cap on visits and no copay and everyone is covered, hardly anyone hesitates to go to the doctor when they need to, which gives them a chance to catch little issues before they become big issues and spot contagious diseases before they spread to the rest of the population. And here’s another way the focus is on prevention: when I had my babies, the midwives came to my house to check on us every day for the first 10 days after the baby was born, and then the Health Visitor (a community nurse) came to the house once a week for six weeks, and then I could go to her clinic (held once a week in town) for as long as I wanted after that with any concerns I might have (as well as being able to see a doctor — my choice). It’s all done to ensure the mother and baby are healthy and well, to support breastfeeding, and to catch problems as early as possible. I was utterly shocked when I found out that most new mums in the US are simply sent home with their babies, with no follow up in the first six weeks, and left to muddle through as best they can!
- None of this actually tells you anything. Isolated anecdotal stories (like these) don’t actually give anyone the information they need to decide the merits of one system over another. All it does is tell you whether my particular doctor was good or bad, whether the nurse I encountered was having a good day or a bad day, whether the receptionist liked her job or hated it. There are good stories and bad in both systems, and it just depends on who you talk to. It’s much like public schools. You could ask parents across the US to tell you what they think of their kid’s school and you’d get a whole spectrum of answers: some schools are good, some are bad, some districts are rich, some are poor, some teachers are passionate, some have lost the will to live. But none of these things tells you whether the overall concept of publicly-funded schools is a good or bad one. If you drew your conclusions based on a bunch of stories from a handful of people about their personal experiences, you’d only be getting part of the story. And it’s no different with the concept of public healthcare.
I can sum up my experience of the British and American healthcare systems in one simple sentence: given a choice between the two systems, I’d choose the NHS in a heartbeat. And though this is the experience of only one single person out of millions, unlike so much of the propaganda and hysteria surrounding the current healthcare debate, it is the absolute Gospel truth.
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Addendum: This is an incredibly important issue with a lot of misinformation flying about. If you have experience of both the US and UK healthcare systems, I invite you to please leave a comment here and let us all know what you think of both systems. This debate needs more voices of experience and a lot less uninformed fear.
Stumble it!
This is a VERY well written a fair post. Of course, my opinion of the NHS is equally subjective and I’ve witnessed some horrific things – but, like you, I’ve softened slightly after living in America simply because of the COST of this amazing health care.
This debate is interesting; especially the misinformed neurosis of right wing propoganda in the USA. This posting is excellent although rightly tempered by it’s admission of anecdote.
Overall the average person is going to be better off in the NHS. The NHS is undergoing huge change with more emphesis on choice, prompt access and reduced waiting times for treatment, following years of increased investment. The propoganda is out of date and ridiculous (especially for waiting times).
I’m a GP working in the UK. I’ve lived in the USA in my adult life and also worked in New Zealand as a Doctor. The NHS is not without problems, but no system is, but on balance I believe it is the best in the world.
For my 13000 registered patients (with my fellow 9 primary care doctors) we offer appointments based on medical need on the same day and in a week or so for routine problems. We do some evening and weekend surgeries. If patients need a home visit they will have one on the day. We have nurse practioners who triage same day emergency problems. Patients can attend as many times as they like / need. We can do as many tests that are needed in the surgey including ecg, blood tests; or at a hospital 4 miles away including same day ultrasound, xr, and CTs. MRIs can also be arranged. Patients with sinister symptoms not needing immediate admission will be seen within 2 weeks of referral, often sooner. Most routine conditions from referral to operation will be completed within 4 months, often less. We have in-house counselling, physiotherapy, midwife, health visitors, district nurses and social worker. Referrals are done on line and I can book appointments for patients from a choice of hosptials and specialists. Patient records are fully computerised and investigation results are returned electronically. We call patients on the telephone for quereies. We process 100s of presciptions a day. We do minor surgery, cryotherapy, travel vaccinations, student teaching, training doctors, we routinely visit nursing homes and look after these vunerable people as we would the younger.
For chronic disease we have 1000s of patients that see specialist nurses in the practice for diabetes, COPD, asthma, heart disease, kidney disease etc. We can commence insulin in house, perform spirometry etc; as many times as the patients need.
We manage our patients based on clinical need and evidence-based medicine.
This is all free at the point of need (or via taxes less then 10% national income). Only about 10% prescriptions have a cost paid for by the patient (£7, c.$10); the rest are free.
About 10% of patients need a referral for specialist care.
Contary to the government-controlled nature of the NHS as feared in the USA, I’m an independent, self-employed contractor in the NHS. The partners own (via mortgage) our well cared for grade 2 listed building and receive income based on our list size, the breadth and depth of services we offer and the quality of care. We run our own management structure and employ 40 staff and are responsible for their tax / pension etc; the tax payer isn’t.
In the UK GP services account for 90% of patient contacts (350 million per year) in the NHS with only 10% of the budget, This equates to about 1.8 billion patient contacts in the USA per year.
Patients can have private health care too, and now it is unlikely to not affect your NHS care.
Recent problems are 1. the media-obsessed myth over over-paid GPs (in fact since the new contract for GPs the perceived increase of income has disappeared via the different way we now pay for pensions and national insurance, and 4 years of pay freezes until this year’s 0.7% increase), fortunately GPs are the most trusted group of individuals in the UK; 2. unnecceary government dictats; 3 the hospital system – often dirty, inefficient, low levels of nursing prioritising paperwork over patient care mainly because of poor management; 4. mental health services.
However, most of it is getting better, with many brand new hospitals – and at least the current financial climate should improve efficiencies.
That is a wonderfully written post; thank you for writing it.
Thank you so much for detailing your experience of the NHS, I’ve been absolutely disgusted over the past few days at the insinuations of American right-wing politicians that the NHS allows people to die, mistreats people etc. Even one of our own politicians has joined in!
If Fox News and their cronies wanted to tell people the true story they’d consult those who use the NHS, that is to say most people living in the UK and I know they wouldn’t be happy with the response. What you have posted here is the absolute truth, there is nothing to be gained from misleading people about the NHS and I’m glad your experience is up here, ready for someone who might be interested in the truth to stumble across it.
The American right have offended a lot of people in the UK with their outright lies recently and the response online is proof that we’re not going to sit and take it – we’re not going to be used in this way for these scumbags to harm their own countrymen.
Jesus Christ.
Not everyone who is unsupportive of socialized/universal/public/tit-tacular/wtfever you call it health care is a Republican, a right-winger, a Nazi, or a puppy rapist. Oy.
Well written post, but as you note, Strawberry, it doesn’t really mean jack. I’ve had horrendous experiences with US health care and I’ve also had awesome ones. This has happened while insured and uninsured. Frankly, the fact that no one seems able to talk about health care rationally is a problem and won’t exactly make me see the pro-socialized health care side’s point of view. The responses I’ve gotten usually boil down to “OMG Y DO U H8 POOR PPL?!?!?!?”
Why is it that, when Bush & Co. did this from 2001 – 2009, it was a travesty, but if Obama’s administration & supporters shut down a dialogue about the matter, it’s okay because the dissenters must omg! hate poor ppl! I’m not even talking about the Townhall idiots who are screeching their points, rather, I’m referring to normal people – like myself – who simply disagree or need some clarifications.
What are the clarifications that you need?
I don’t think you are correct to say that this post bears no weight. Although there are personal anecdotes in it, there is also a broader analysis of the overall costs and benefits of each system. The UK has a higher level of public health and longer lifespan than the US and a system that costs about half as much. That is not anecdote.
I appreciate this post for having been so honest about failures as well as successes and for being so reflective concerning her own biases.
I would like to thank this blogger for a sane contribution to a debate that is dominated by insanity.
Bravo! It’s nice to hear some truth in this debate instead of nonsense about death panels, euthanasia, eugenics, bureaucrats on every corner and the rest. How was your dental care whilst you were in Britain? I hear a right-wing Fox “news” person broadcast a scare story about a Brit who fixed his tooth with superglue because he couldn’t get NHS care. I don’t think the TV guy told the audience that dental care was partly privatised by the last conservative government (well, he wouldn’t want them getting the right end of the stick would he?). NHS dental care is not always available these days so If you don’t have it you have to get insurance or superglue. If there were still universal dental coverage on the NHS there would be no need for the superglue, yet private dental care would still not be banned by diktat!
British Dental Journal in 2001:
http://www.nature.com/bdj/journal/v190/n3/full/4800900a.html
Approximately 50% of GDPs nationally concentrate on NHS dentistry (85% or more of their patients are treated under the NHS); 25% treat more than 70% of their patients privately; the remaining minority of practitioners fall between these two positions treating moderate proportions of both private and NHS patients
I wish I had wrote this myself. The other big argument I have for the NHS is that there is so much less of a lawsuit culture as people aren’t afraid of the cost of their care. Also, the NHS can negociate for prescriptions at a cheaper rate because so many people will receive them.
I love being able to go to my GP so easily without paperwork and the bureaucracy. Love it.
Plus birth control is FREE!
I am another American who loves the NHS!
I am going to link to this post (if you don’t mind).
I have been avoiding the whole conflict because most people make their decisions based on ignorance and the ‘horror stories’ they hear and it is just so frustrating to me. Both sides have horror stories but I think it is truely horrific when someone does not go to the doctor because they do not have insurance and once they have insurance they are diagnosed with advanced stages of cancer and only 2 weeks to live.
And your point about spreading the cost of healthcare across the whole country was exactly my point as well. Whether I make $100 a month or $100,000 I still have to make the same insurance premiums.
Thank you so much for this wonderful, informed, very well-written post amidst all the madness surrounding this topic. I am an American who has lived in Britain for the last 20 years. Like yourself, my only knowledge of the US health system was under the umbrella of my parent’s coverage. Long, long waits in the ER when as an active little one I had various breaks and sprains, but was patched up and fixed up just fine. Paid for what I had to pay for as it was not free there (yes, birth control). Didn’t have healthcare between leaving university and working my first job but shortly after that moved here to study. I have found the NHS to be wonderful in caring for my father-in-law, mother-in-law and other of husband’s relatives as necessary.
And myself, when I most needed it. I contracted (came down with? caught? I still don’t quite understand) a very rare thing called Gullain Barre Syndrome. Can be life-threatening, but not when you ring NHS Direct for advice (so brilliant), go to a very well run NHS Walk-In Centre (was between Doctors at the time, had just moved boroughs), are diagnosed by a brilliant nurse, sent straight to A&E – not my local hospital, but the right one some distance away, who could deal with the problem. Was in hospital for two months from start to finish – ward, HDU, Intensive Care (10 days) back to HDU, back to ward, finally in physical rehabilitation. Faultless, brilliant, caring care from start to finish. I was paralysed for two weeks (that’s what GBS does to you). Fed, washed, cared for by brilliant nurses, the top neurologist in Europe (one of the top in the world), one of the best specialists on GBS that there is in the world, all these people contributed to my care.
Do I mind paying for this through my taxes? Do I heck.
This is so well written! I’ve passed this along to my family and friends back home.
I’d pick the NHS in a heartbeat and I’ve got great cover. The neocons talk about ‘rationing’ – which I think was done when I needed a specialist X-ray that didn’t exist within my county and I had to fight the insurance company to cover one in another county, or when I had to call around to umpteen specialists to get one that would ‘take’ my insurance.
If the NHS was so bad, why has nobody voted it away?
Stupid necons.
If the NHS was so bad, why has nobody voted it away?
If the NHS is so wonderful, why doesn’t the US have it?
It works both ways.
PS- As I said above, not everyone against socialized health care is a right-wing, Republican, Nazi-tastic, puppy raping fascist. Many of the people against it are normal people with concerns and questions that are being swept under the rug Democrats under the guise that they’re being “un-American.”
Woah, is it 2006 again? I thought the HOPE!CHANGE! Administration was supposed to change all of that?
If the NHS is so wonderful, why doesn’t the US have it?
Ignoring the apparently ignorant (and somewhat jingoistic) assumption that the US has the “best” & “greatest” everything; where as it clearly dosen’t, especially in this case ……
Because the US system is for profit as a primary cause, not health first.
Hence why most medical decisions are based around cost and not what is best, i.e. unnecessary treatments by medical practitioners who do it only because the insurance people cover it.
Thank you Strawberry for putting time and effort into writing this. I am guiding my friends to your post and emailing a few people while giving you full credit for this very informative post.
What amazes me is the very people who would benefit from a service like NHS…are the most against it. Such a fear of socialised medicine yet they have roads, schools, libraries, public services, military to defend our freedom all paid for by our taxes.
I’m another American Expat who would prefer something like the NHS to what the US Health Care system is like right now.
Having had both health care systems myself I would pick the NHS. Its not perfect. The US system if far from perfect as well. My mother has had horrible care in the US. Kaiser over medicated her. She nearly died. I have gone into the hosptial and argued with her doctor who said she was just feeling the pain of becoming elderly when she had a broken rib. The care given in the US and the UK are comparable. You good and bad doctors in both. Caring and uncaring nurses in both. Clean and dirty hosptials in both.
The fact that no one goes without medical is the bottom line. No one should have to pick between eating or medicine. No one should have to pay $100s just to get the medicine they need. No family should lose their home because a family member becomes ill. Its wrong.
People who say that because they have insurance so who cares if anyone else does is just selfish. One day they too may have to be frightened because their child is ill and they cant afford to see a doctor.
I hope that the US wakes up to the reality of the situation. I hope my sister who has no insurance because she was laid off and cant afford COBRA will get coverage. I hope no one ever has to go through what you have had to go through to get medical coverage for their kids.
Great blog entry Strawberry. Well written as always
I am an American living in the UK. When I first moved here, I had incredibly horrible preconceptions about what the NHS would be like and really dreaded having to engage with the healthcare system here. My first few experiences were a bit underwhelming from a customer service perspective, but that had very little to do with the NHS and far more to do with me expecting American cheerfulness and ‘bend over backwards’ customer service in British culture – which just doesn’t exist here, not even in restaurants. Now that I’ve had nearly 2 years of experience with the NHS as well as one of the UK private insurance providers, I can categorically say that I prefer the system here to what I had in the US. My husband and I will NEVER have to have the same conversations which I know my friends and family back home have about ‘how are we going to pay for our kids insurance if you change jobs?’ and ‘we just can’t afford the copay on that procedure this year so you’ll have to wait’. We will never have to worry about not being able to afford a prescription, or choose taking my prescription over buying groceries – positions that some people I’m close to in the US have been put through. And we would never, ever be put in a position where we couldn’t have a child because we couldn’t afford the prenatal care or delivery deductibles. None of those pressures exist in the UK’s socialised medicine system and I don’t resent the taxes I pay to support it – not by a long shot!
Julie,
I totally agree with you! I am an American living in England (moved here last year with my husband, who is British). Within 2 days of arriving in the country, I had my first appt, my diabetes medications sorted, and no worries at all! I can usually get an appt at our local surgery the same week – unheard of where I moved from in the States.
For the people that think its ‘free’, we DO pay for the NHS. It comes out of our paychecks. In the US, you pay out the nose for medical insurance. As a single, I was paying about $100 a month. If I wanted to add my son, it would have almost doubled, and at the time, I couldn’t afford that. Heaven forbid you had to have a ‘family plan’. I’d seen some that were upwards of $800 a month!
The only complaint I have, and its not really a complaint but more of a “I wish this were different”, is that mammograms are not ordered until a woman is 50, and cervical screening is not ordered until a woman is 25. 2 of the most common diseases in women that are more likely to be treatable if caught early enough. However, that being said, you WILL get an appt for a screening immediately if you go to your GP and tell them you found a lump.
Though I am planning on staying permanently in the UK, if it happens that we do move back to the US, I dread the thought of going back and dealing with the red tape, bureaucratic BS, co-pays etc.
Thank you, OP, for a very informative, well written post!
Susan,
If you get to 50 please press for a mammogram or earlier if it is worrying you or if you ‘find a lump’. My mum was screened at 53 as it works in a 3 year cycle. They found a lump and gave her excellent care but she died of cancer at 61. I am told I should go for a mammogram 5 years before she was diagnosed but the age still stands at 50. I think I shall be either finding a lump at 48 so I can be screened or having a private mammogram.
Beth
Beth,
Definitely ‘find’ one beforehand. Its SO important that women get screened earlier than 50 I think!
Susan
I love how Susan and Beth, clearly point out “lie” so you can get a screening. Classic abuse of “free” systems.
A great article which covers the issue accurately and concisely. I am dual citizen, living in the USA right now and am horrified at the stories which are being circulated by the Republican party to protect their corner, risking the health and livelihood of the majority of Americans. Absolutely abhorrent. It worries me to death that, if my husband loses his job (which is auto industry related and tenuous in this economy), we will be without health insurance or will be paying unbelievable premiums to retain it. Health care should not be linked to a job. It’s a right (and a privilege), and one that should be available to every person in the country. And, by all accounts, the government here already runs a top line health system providing top class treatment —– the V.A. Check out John Stewart’s show with Bill Kristol.
When you say “top line”, Tammie, that would be the one recently receiving a great deal of media coverage for small details like their flagship hospital, Walter Reed, being infested with vermin and all sorts of other problems? Yes, Jon Stewart tricked Bill Kristol into saying something really dumb about the VA, but that’s hardly proof of anything relevant.
Walter Reed is NOT run by the Veterans Administration, but by the Department of Defense. The scandals you refer to have nothing to do with the VA, which provides excellent care and low administrative costs. If we weren’t hamstrung by ideology, ignorance, and the power of the insurance and drug industries, we could use it as a pattern for a national system.
I have just listened to the BBC’s Robert Peston chatting to Jim Chanos (not renowned for being a bleeding heart liberal). It is currently still available to hear online, via the BBC iPlayer – Radio 4, being the second episode in the series: ‘Peston and the Money Men’. According to Chanos, the future outlook for some of those profitting from the current (old) US health-care industry is pretty bleak. One interesting statistic (quoted in the final 3 minutes of the 29 minute program), concerned the cost of a single pacemaker. In the US the cost is $35000, while in Europe the same item is priced at $5000. Of course a 600% markup must be for R & D! I thought that this (apparent) fact might interest some other readers, if not you, James.
Jim UK – about dentistry. Until I moved to America, I had not been able to see an NHS dentist in fifteen years. FIFTEEN.
I was in there for about three hours my first time.
Yeah, don’t even get me STARTED on British dental care.
This is unheard-of. Obviously for Americans reading, we don’t spend 15 years waiting for a dentist’s appointment. Despite all the jokes
This person’s case is very, very unusual, and who knows what factors are involved that weren’t reported in his post.
I’ve never had a problem getting an NHS dentist. My current one even opens late on a Wednesday evening to do a specialist surgery for us nervous patients. No idea how Roland Hulme managed to wait 15 years, unless it was for a dentist to personally attend his home…
The only thing with British dental care is that they won’t do purely cosmetic dentistry on the NHS – hence the wonky teeth stereotype. But that’s fair enough, really.
Yeah, I’ve had to hunt around for a dentist who will take NHS patients at times, but whenever I have they’ve been nothing but efficient.
Oh and whenever I have not been able to find one there’s always been the emergency walk in centre which is always willing to see you, I honestly cannot imagine the horror story about superglue can be formed by anything other than ignorance of the system. There IS emergency dental care for exactly that reason and I’ve never had to wait more than a few hours for it.
I moved to a different county, rang up the one of the local dentists who booked me as a new NHS patient immediately.
Asked me if I’d got any problems, invited me in the next day, etc etc etc
Feels like Rob has some kind of agenda?
Sorry, I meant Roland, the original poster may have some kind of agenda (or is personally ineffective in some way, actually, the NHS would help with that as well).
Waiting 15 years for a dentist is ludicrous, a coulpe of weeks if it’s not an emergency, yes, 15 years. never.
My husbands family dentist is an NHS dentist, so I thought, ‘great! Ill sign on there’. However, they only accept children as NHS patients.
My husband saw a private dentist in the UK for a filling. It was cheaper than I have had to pay WITH insurance in the States.
You must not have been doing it right. I mean 15 YEARS!? I registered with a NHS dentist in 1 day, and got an appointment two days after, and he is fantastic! Even as a child I had braces paid by the NHS, and have always been complimented on my great teeth! x
I am a Brit living in the US. I do have good dental care paid for by my husband’s employer. Let’s not get confused here, the dental care is separate from our medical coverage, as is the case with plenty of other people. My point is, that this excellent article was discussing general and specialised (not dental) care. I am pretty sure that there are even more people uninsured for dental in the US than there are for medical.
Roland, do you mean you waited 15 years for a dental appointment or 15 years to register with an NHS dentist?
Your inability to get NHS dental care validates the point I made – the NHS cannot be blamed when someone has no access to a dentist, because dentistry was part-privatised by the last conservative government. It no longer aims to cover the whole population.
For the record, I have not had an NHS dentist for SIXTEEN YEARS (almost to the day – I failed to qualify once I left home for university).
Fifteen years?
Yeah, right. I do not believe that for a second. Want to know why?
I have multiple chronic illnesses, and none of my local dentists feel qualified to treat me because they don’t know enough about how they affect my dental health. I bounced around the system for a while before I could get a referral to the local dental hospital. That ‘bouncing’ lasted 18 months. That’s the longest I’ve ever had to wait for dental care, and while it’s not great, it’s nothing like 15 years. I don’t personally know anyone who’s had to wait that long. Not at all.
Thank you, S, for sharing this. No system is perfect, but the misinformation flying around is driving me crazy. It’s always nice to hear from someone who has REAL knowledge and experience of a subject.
When I left Uni here in the UK I became really, really ill, and couldn’t work. I was on benefits for a while and it was horrible. I couldn’t explain what was going on – I was exhausted, in lots of pain all the time, having rel mental problems and my brain wasn’t working like it had at all. I couldn’t understand why I was stupider than I was.
Of course, my NHS doctor diagnosed me and sent me to an endocrinologist, who diagnosed me as having an underactive thyroid and various associated conditions and tested me for a range of other things just in case. I’m on medication for the rest of my life, but it’s free, and I never, ever have to worry about it. If I even feel a bit wonky I’ll be referred back to hospital, and ok, while there are delays, there are sneaky ways round, and I can pay to go private at any stage knowing I can go back to NHS at any stage.
It’s not perfect at all – but bear in mind I was ill as an adult, but before I started working full time (because I couldn’t) if I was in the USA, how could any of that happened? My medication is necessary to me to live – so it’s free. It completely blws my mind that if I was in the USA I’d have to pay – I honestly can’t conceive of a world where people have to *pay for insulin* – so what, a choice between food and living??
It also means that as long as I get my free card, I’ve got free healthcare all over Europe – so going on holiday or away for work I’m covered…..
“It also means that as long as I get my free card, I’ve got free healthcare all over Europe – so going on holiday or away for work I’m covered…..”
Nope – it means you get access to the same system as the natives of that country get, which in most cases is most definitely NOT free! In France, for example, you have a substantial co-payment unless you qualify for their means-tested exemption, and in Germany the system is largely private with premiums required, so I’m not sure your EHIC would get you anything at all. In Ireland, it means you can visit a doctor for a co-payment of about €40 – cheap, but again most definitely not free.
Moreover, the EHIC leaves substantial gaps in coverage, which is why you will be strongly advised to have private insurance. Air ambulance, medical evacuation/repatriation, flying your body home if you die – all excluded.
Finally, the EHIC’s only for holidays or short term visits: if you *move* to another EU country for that work you mentioned, you’re subject to their healthcare system, not the UK’s. Move to Germany, you will have to register with and start paying premiums to a ‘Kasse’, one of their health insurance companies: no more NHS, no more “free” anything.
It always baffles me how many Brits seem to assume that everywhere else has an NHS as well. They all have some form of healthcare system, but none uses the same approach as the NHS!
My husband was taken seriously ill in France a couple of years ago. The ONLY things we had to pay for were the valium he was intially prescribed (and that was much cheaper than a British prescription) and the taxi to the hospital when the valium didn’t work. We waved the EHIC at the medical staff at every opportunity, and his care in hospital was all covered.
However, you are right that it is adviable to have travel insurance; that covered my extra hotel bills, our missed holiday, and our repatriation.
If you are on holiday in Germany visiting me and have health problems you will be treated free, this is for each EU citicen the case anyways as well if you are from somewhere outside the EU i.e. the States. There are exemptions for people who visit only with a visa allowance, still one of part of such a visa allowance has to do with who covers the costs in case the visitor needs health care…. Been there with visiting friends who needed medical help incl. emergency room and intensive care for days in hospital. Got a letter with some questions to fill out from the council if I remember right and that was it…. on the other hand if I travel outside the EU I have an additional travel health insurance just in case I get ill during the travels and need medical help and do not want to be send away or bankrupt afterwards.
It is pretty strange to see a so called “christian” nation that is not willing to find a way to provide all their citizens with health care without getting paranoid about socialism, the banking crisis and bail out of banks, car producers etc…. that is called socialism to a much worse degree a national health care system would mean…. at least in a NHS system the tax payers have something from their taxes, the bank bail our only meant depth being socialised and profits still taken away by a handful of capitalists….
Regarding dentistry – we do have dentists. Some are NHS, others are private.
I receive excellent (private) dental care and use the NHS. My wife has BUPA (private insurance) as part of her salary package, though she has never used it.
Perhaps we have more choice?
I don’t feel I can add much that hasn’t already been said either in your post or in others’ comments, I just wanted to say what a fantastically well-written post this was. I too have shared it with my family and friends. Thank you!
Thanks for sharing. I’m with you: I’d choose the NHS over the current crappy US system anytime.
As an American who was living in Britain for 10 years, I also have a fair idea of what’s good and bad about both systems.
I returned to the US earlier this year by choice. Not because I hated Britain but because I was ready for a change that also included four actual seasons. I’m self-employed, and in Massachusetts where I live, it’s one of the more progressive states. Health insurance is required, or you face a fine (or something like that) but getting health coverage isn’t negotiable for me so I’m fine with that.
Getting personal health coverage here has not been easy and has produced feelings of rage and helplessness in me. Want a doctor in your town? Check the website. Yep, make an appointment. What? Gosh, the website is … wrong…. she only practices in a town 10 miles away now. So I tried again. Nope. And I don’t own a car, either. Eventually I realised that I’d need to change to a different (more expensive) plan if I wanted a doctor in my town. At first I was told I’d have to wait for the 6 month mark to change my plan, but once I kindly explained in a very sad voice that their website is wrong and that I didn’t drive, they consented. Sheesh. But I had to pay a full month in advance. Now the billing is slightly haywire but I’m told it’ll get corrected on next month’s bill. Every penny counts when you’ve just moved, freelance and trying to get your business established. Oh and the best part? I found out from my practice’s receptionist that the hospital in our town doesn’t accept the coverage I had, hence why none of the doctors in town accept that coverage. WTH, couldn’t I have been told that when I enrolled? I mean, give me the all the facts, at least! Gee, thanks, current American health system!!!
The NHS is breathtakingly simple and painless in comparison. When you’re dealing with your health, the last thing you want is paper-pushers, admin hassles and misinformation.
One thing to note is that prescription meds are not ‘free’ in either system. In the UK, unless you meet certain criteria, you pay a flat rate of 7 GBP per prescription. I’ve only had one prescription here and it was $14.99.
Just so you know, 90% of prescriptions issued on the NHS come under the blanket of being free. It’s only 10% that have to pay that £7 charge, and it especially doesn’t apply to anyone who needs their medication to survive.
So, effectively, they ARE free.
Hi, i was brought here by an American friend living in the UK (through a Facebook link!). I came to read this, as the Repubilcans stance against the NHS has really hit a nerve with us Brits.
If i was born an America, I can quite honestly say, I would be probably not be alive today….
I was diagnosed with type 1 diabetes at age 14, during my high shool years. It came as a bit of a shock, but I collapsed at school during an exam, and the next thing I know Im in my local NHS hospital speaking with the Diabetes doctor (Dr Swift, legend that he is from Leicester Royal Infirmary). He spent 4 hours, thats right FOUR hours talking me through what had happened to me, and what I was now going to have to live with for the rest of my life. Insuline injections, Hypo’s, Hyper’s and the later in life problems with eye sight, feet and blood pressure. He then saw me once a day for the next eight weeks to essentially train me on what the symptons for a hypoglycemic attack were, how to test my blood sugar levels, how to inject the insulin etc. I also had my diabetic nurse pay me a home vist twice a week to check up on me until I told the clinic she no longer needed to do so! I was given a medical exemption certificate which makes me exempt from all prescription charges (Brits pay around £8 per prescription given to us by our docters, no matter what is on it) for the rest of my life, I visit the diabetic clinic at my loca hospital (15miles away, one has opened in my home town, but the nurses in Leicester have helped me through my darkest times!) every 6 months and have so many specialist tests done in an afternoon that it boggles the mind. I also have the number of my local diabetic nurse whom I can ring any time of day, and a sort of “hotline” to the clinic its self who I can call and speak to my doctor, feet specialist, eye specialist or even a dietician if I need it.
All of this care costs me, in my eyes, nothing. I pay my taxes (which are no higher than most other developed countries, and quite a lot cheaper than others at the band I am in) and just cannot comprehend people with a condition like mine, or worse, having to pay huge bills are simply accept they are going to die! How can the Republicans be spreading lies about something that does all of this for people like myself, whether they have insurance or not? It just boggles the mind. I would love to see some counter arguments and perhaps actual FACTS to give a little substance to the bile these are spreading but I fear we will never see it (except maybe about the Dental care, but as others have said, 75-80% of people are still seen by NHS dentists, I go private because that is free due to my diabetes!).
Stephen Hawkings summed it up the best, by simply saying “If it wasn’t for the NHS, I would not be here today”.
Don’t forget the problem of assymetric information, in the US it is in a doctors favour for the patient to recieve further care. In the UK they are not financially connected and the level of treatment has no effect on their financial circumstances.
A humane way of dealing with health i think.
Not quite true – GPs can opt in to “payment by results” whereby they get a bonus for improving patient outcomes.
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Great post – just adding a comparison. Whilst on holiday in Florida I suffered with a tooth infection. I was in great pain – I was able to get to a doctor fairly easily but the shock was the cost. It cost me me over $300 for the consultation and some antibiotics. It’s only then that you realise what amazing value we get in the UK and we just take it for granted and don’t worry about it. And on prescriptions whilst they cost a fixed price in the UK – if you are unfortunate to have to take prescription drugs on a frequent regular basis there are options to make a one off payment to cover the year which is far less than all the repeated prescriptions.
[...] take the time to read a fellow re-pat’s post about her take on national healthcare over at Potential and Expectations. She lived there much longer than me and is much more eloquent than me. - BTW, she is an [...]
Thanks for such a well written post, I am an American living in England now for 4 years and find that our stories are so similar. I too at first was skeptical and concerned, but then when I started using the NHS I marveled at how I had been so unconcerned at the American system! We (Americans) can really do better than where we are now with our healthcare but it is difficult to picture until you’ve experienced it.
I wouldn’t rate the NHS as 4 stars, but I too prefer it over the capital system (and I’m Republican). We have so many services in the USA that are socially and politically run, why not have one of the most important added to the list?
Schools
Fire Departments
Libraries
Hospitals
If children must be educated, fires must be put out and books made available to all why can’t we agree that health deserves the same status?
@Lisa Rex – Well, it depends where you live. In Wales, where I live, all prescriptions are free – http://www.wales.nhs.uk/page.cfm?pid=9586
This is an excellent post. As a British person, some of the things I’ve heard about the NHS are astonishing, and remind me of something you’d expect to hear about Nazi Germany. A balanced opinion is what is required, not scaremongering.
The protesters with healthcare seem to be protesting that everyone else shouldn’t have it? Madness in my mind.
Thank you. I’ve had a few American friends asking me recently if the Republican slanders are true. I was astonished to hear those ridiclous lies. Now I can link them your article. I’ve always had promt and excellent care from the NHS, as have my entire family, young and old.
Lisa Rex is right about prescription charges in the UK – but there’s a wide range of conditions where one is exempt from paying them. Basically, as far as I understand it, if you need it to live or function on a day-to-day basis, not only is that medication free, but all other medications you might need are also free, because of side-conditions and the fact that long-term conditions often leave people more susceptible to other things.
And yeah, it does come out of my taxes – but it’s only because of my healthcare that I’m actually well enough to have been able to pay taxes for the last 15 years. I’m in a good job, so adding it all together, I’m an investment. Without my thyroid medication I’d be reliant on benefits for the rest of my life, and costing a whole lot more to the state in the long term.
This is not quite true. As a kidney transplant patient, I was required to take immuno-suppressant therapy to prevent rejection of the organ, which would have either resulted in death or the need to re-commence more expensive dialysis. My medications were not free, although I could pay for a yearly ’season-ticket, after which I didn’t pay anything.
Have you seen this? http://www.dh.gov.uk/en/Healthcare/Renal/RenalInformation/DH_4138605
Even if you are unfortunate enough to be in the 10% who need to pay for a yearly ’season ticket’ – and if you were poor enough to be on welfare you wouldn’t be paying anything anyway – that ticket works out to £2 per month. Very, very cheap for healthcare.
Thank you for an excellent and thoughtful post. So little of what’s being said right now sheds any light on the situation. I’m glad you took time to help.
Thanks for writing this – it is very useful to have the NHS put in context. I haven’t been following the debate on healthcare in the US closely but with a large proportion of the population not covered I always thought it was a no-brainer!
I really only experienced maternity and pediatric care in the UK, but I was very pleased. Like you said, I especially appreciated the midwife visits after bringing Kate home from the hospital. We had a lot of trouble establishing breastfeeding, and without the intensive help (and readmittance to the hospital!), I don’t know how it would have gone.
I am immensely appreciative of the care and thought you have put into writing this detailed post.
Thank you.
I enjoyed your article, but it’s only one side of the story. I have a very different opinion.
I’m an American living in the UK for about 3 years, and I prefer the AMERICAN system over the NHS. The NHS is truly a mixed bag, and lot of it depends on WHERE YOU LIVE. Instead of getting tied down to your employer for healthcare, in the UK you’re tied down to your address. It’s a bit like public education and good schools — if you want good healthcare you have to move to a place where the hospitals and doctors are good.
I live in West London. I have NO CHOICE of my GP. All the other GPs in my area are fully booked. If I don’t like my overworked doctor, the best I can do is choose on of the other two equally overworked doctors in that office. I have no other choices, unless I move.
My doctor makes all the decisions and I don’t have much choice about it — and usually neither does he. Here’s a textbook situation:
When I had a foot injury, I knew that I needed to go to a physiotherapist, and I could have worked through it quickly. The doctor agreed, but the NHS doesn’t allow him to make that referral. Instead he could only refer me to a podiatrist specialist. It took two weeks to get that appointment. The podiatrist also agreed that I probably needed to see a physiotherapist, but the NHS wouldn’t allow him to make that referral until I got an MRI scan. It was another two weeks before I could that appointment, and then another week to get a return visit to the podiatrist, and finally he was able to write a referral to a physiotherapist. Guess what? There aren’t many of them in my local area, and so of course they are extremely overbooked and I would have had to wait about another 3 weeks or more to get an appointment. Imagine limping around on a bad foot for about 2 months before getting the treatment that you really need. In the US, faced with a similar problem, my PPO insurance plan allowed me to go *directly* to a physiotherapist, as long as it was within their network, up to 10 times per year, for about a $25 co-pay. I would have gladly paid that to get the immediate care I needed!! And it wasn’t a gold-plated insurance plan, it was a very basic one compared to some of the ones I had when I worked in the US. American healthcare for the win!
What about employer insurance in the UK? Almost worthless, in my opinion. Since the NHS covers nearly everything, a company has no incentive to offer a comparable plan. It’s only good emergency cover, and only for very limited kinds of emergencies. For my wife’s pregnancy, the only things they cover are the most extreme emergency problems that would probably result in a miscarriage anyway. Furthermore, private insurance often won’t kick in until AFTER you’ve gone through the NHS! For my foot injury, my company’s insurance company *did* cover the cost for a physiotherapist, but only *after* the podiatrist specialist would approve it. Because I was able to use it I went to see a private physiotherapist only having to wait 1 week (for the insurance papers to go through), but I still had to wait over a month.
The NHS does *not* believe in preventative care. As he said, you only go when you’re sick — usually from something that was completely avoidable!! There’s no such thing as an annual checkup here. In America, I would go every year on my birthday for a checkup, blood & urine workup, and as I get older, prostate and other such exams. And it was always covered by all of the insurance plans I had, because they have an incentive for keeping you healthy, and nipping bigger problems in the bud. In the UK, I had to beg & plead my NHS-appointed GP to even give me a simple blood & urine panel to check for cholesterol, etc. So sure, if you get prostate cancer the NHS will take great care of you. But if you want to avoid getting prostate cancer in the first place, American healthcare wins again.
A few other issues I’ve had with the NHS:
- my pregnant wife practically missed her first trimester pre-natal scans and screenings because (as usual) the local maternity wards were full. First the GP would *not* refer us to the hospital of our choice because it was a little farther away. The problem is, all of the local hospitals were rated in independent studies as being near the bottom of the list for worst maternity wards in all of the UK (not just in London, but the entire UK). Then our case went into a black hole and unless we called and pushed the GP, she probably would have had the baby before we got re-assigned. We ended up having to pay for our scans from a private company. (Again, the company’s insurance plan doesn’t cover it because it’s not an emergency.’)
However, after all our pushing, we finally got reassigned to one of the better maternity wards in London, and now things are going very well. It’s further away and takes longer for us to get there, but the facilities and the care are so much better. It all has to do with location.
There are some good things about the NHS. Pregnant women get free medicine – the NHS co-pay is waved. My wife also has a chronic illness which requires regular scans and medications. She had to wait a bit to get referred to a specialist, but once that happened she is getting good care and the prescriptions are quite cheap because she only needs to pay the low NHS co-pay. I would also say that if I had a car accident, heart attack, or other emergency, the NHS would probably give me excellent care. (Then again, I felt the same way about the US, too.)
And dentists… don’t even bother. The NHS dentist offices in my area look like medieval torture chambers. I went once — flickering lighting, dirty, ancient equipment. They wanted to take an X-Ray and I told them to skip it — I’d probably get sterilized from the shifty-looking X-ray machine.
In my experience, as a pretty healthy mid-30’s male, is that I prefer the American health care system and I would not want it to turn into the NHS.
My biggest fear about the proposed changes is that the insurance companies will cut down their coverage and only offer limited, emergency care because they will have no incentive to compete in the basic-care market. I liked the preventative care that I got in the US and the ability to go directly to the specialists without having to be pre-screened by my GP. I liked having a choice of GP that’s not limited to where I live. Ditto for maternity care. I may have paid a bit more for the care, but I felt that I got my money’s worth.
“When I had a foot injury, I knew that I needed to go to a physiotherapist, and I could have worked through it quickly. The doctor agreed, but the NHS doesn’t allow him to make that referral.”
Umm, that’s not the case. I needed physio following a back injury, my GP referred me herself and I started treatment within 10 days.
Secondly, the NHS is very big on preventative care and GP surgeries routinely invite people to attend for various tests and check-ups. If your doctor isn’t doing that I suggest you have a word with your local health trust because they should be.
My experience was that, both times I’ve needed a physiotherapist (on the NHS), I’ve gone to my GP (in different areas of the country each time) and simply asked, and been referred within two weeks. Once I was not referred, because the GP had a set of recommended exercises for my problem, which I tried and which sorted it out. Had the exercises not worked, the next step would have been… to refer me to a physiotherapist.
Is it possible that your GP was ruling out a problem which physiotherapy would have made worse?
Interesting – I have never once been invited for any form of screening or preventative care by my GP except the routine vaccinations (MMR, Polio etc). When I wanted to get a meningitis vaccine before going to university, as was apparently recommended at the time, I had to order and buy the vaccine myself from another town, then deliver it to the GP surgery to get injected with it!
I know my mother has had some screening (breast, bowel and cervical cancer, I think, off-hand) – two of those don’t apply to me, of course, and presumably I’m too young to be screened for the other. I have literally never received any unsolicited contact from my GP: every single one of the handful of interactions I have had has been at my request.
My own experiences of the NHS have been quite negative, from very nearly dying during birth (complications in a hospital inequipped to deal with anything more than a papercut: the lone doctor in this micro-hospital was away at the time) to being offered a multi-year wait for a CT scan. The extra hoops to jump through for a referral sound very familiar as well. Kate, before dismissing his experience, bear in mind there are many separate ‘trusts’ within the UK, with different rules and procedures as well as different classes of GP with different referral budgets and constraints. It’s quite likely your particular GP has fewer referral constraints than LondonMitch’s.
My most recent GP visit, four years ago when I returned to this area and registered back with my old GP, entailed a total of five visits to register: two initial ones (to see the GP and then the nurse – on different days, because they aren’t scheduled sensibly), then the nurse referred me to the GP because she thought I had a cardiac arrythmia, so the GP referred me back to the nurse to get an ECG (a fourth visit: they only do ECGs on Tuesdays and Thursdays), and finally a fifth visit to get the results: there wasn’t an arrythmia after all. I haven’t seen or heard from my GP since.
On the bright side, I suppose, I “only” pay the government pay a few hundred pounds a month for this (half of that paid directly by my employer, the other half myself through payroll deductions) – 13% of my salary, as I recall.
@ James
“Kate, before dismissing his experience, bear in mind there are many separate ‘trusts’ within the UK, with different rules and procedures as well as different classes of GP with different referral budgets and constraints. It’s quite likely your particular GP has fewer referral constraints than LondonMitch’s.”
I can see your point, but if LondonMitch was told that, his GP was misleading him. They have been able to refer patients for physio for a very long time. It’s true not all GPs operate or are employed in the same way, but that is one basic thing they can all do. Anyone whose GP does tell them they need physio but it’s not possible to refer them, should make a complaint – and move to another practice.
You don’t get the call ins? We get reminders annually for well-women, well-men clinics, cervical screening etc. Anyone can go along and have various checks done. Maybe they think we look like an unhealthy lot lol
Being that the US healthcare system costs twice as much as the UK one, despite your experiences, deep in there you seem to be advocating the NHS. Imagine if the NHS had a 100% increase in funding- all the well known problems *could* be fixed.
I think what is clear through the debate is that its not *the UK system* which is a problem, its the details which are fixated on by the american right wing / lobbyists – this is not systematic of a “socialised” NHS, but underspending, misspent or poorly targeted funds. Easy to fix if you increase funding by 100%!!
It is interesting what you say about the annual check up; I suppose it works both ways, quite unalturistical for the US insurance company to minimise eventual cost of long term treatment. This is something which the UK govt CMO is now starting to talk about as the increase in cost of annual checkups should of course be offset by the reduction in long term care. Since the absurdities of the target chasing era are fading off, there is once again a focus on outcomes, and clearly prostate and breast cancer fatality rates which are high in the UK can be slashed by early detection through these methods.
I’m a UK native with no experience of US health care and I’m a big defender of the NHS but I believe every word that LondonMitch wrote.
I’m lucky enough to now live in an area with a fantastic local hospital; I have a possibly the best GP in the world (same day appointments even for non urgent cases 90% of the time); complete with smiley receptionist, friendly nurses; and a whole raft of services; the larger general hospital is good too and I’ve had first class service from them all over the last few years since being diagnosed asthmatic.
But I’ve been in a similar situation to LondonMitch before now, where YOU may know what you want and be entitled to it but the healthcare people around you don’t permit it. Luckily for me that’s 20 years behind me but there are still places in the UK where choice of GP is limited and the ones that do have space are usually the ones no-one else wants – normally for good reason, they’re bombastic, unfriendly and unhelpful. There are also some bloody awful hospitals out there too – yes they’re changing but they haven’t all changed yet.
In the last 6 or 7 years, there have been some huge strides in modernising and polishing up the NHS, it seems to have battled its way out of the mess it was in the 80s & 90s and found its way into the 21st century. But we’ll need people like LondonMitch to remind us that there are still pockets of awfulness so we can all put pressure on to remove those last miserable remains.
I couldn’t find a NHS dentist when I moved here in 1993 either (thank you Conservative party!). Luckily the private dentist I do use is great; I don’t think I’d move away even if an NHS one was available. A while ago I caught site of an NHS price list & was amazed that for the vast majority of treatment I was only paying a few ££s more than what I would pay on the NHS anyway, so I’m staying put.
wow! the american system sounds fantastic!
Eeerrrrmmmm…..
But what happens to you if you loose your job and the health plan that goes with it?
No… I’m sure your fellow citizens would rally round and offer support when you need it….. I mean, it’s not like they’d let you die just because you aren’t insured, is it?
That’s irony, by the way (I hope you understood what I meant there? Or is ‘irony’ just another metal to you….?.)
I was diagnosed with MS about 8 years ago.
36 hours after falling ill, I had had a CAT scan, an MRI, x-rays, a lumber puncture and numerous other tests. After my first meeting with my neurologist, I found I didn’t get on very well with him, so I chose another. He is ranked as one of the best in Europe. (Mike Boggild – try googling the name with the term MS)
The only paperwork was…. what is your name, DOB, address and telephone number.
I’ve received and am still receiving state of the art drug treatment which costs approx £20,000 per anum! Delivered to my front door, every month.
I don’t pay for any of it. I COULDN’T afford to, even if I had to! Which I don’t….lol
If the drugs don’t work as advertised, the drug company REFUNDS the NHS 80% of the money spent on them treating me.
I receive a subsidised gym membership to help me keep active.
I have a free taxi service whenever I need it.
I have regular check ups and phone calls from the MS nursing staff. They also keep me appraised of all current research into MS.
I have active and ongoing support from my GP/ health team. (GP, 2 specialist nurses, a clinical psychologist and of course the neurologist)
I have the right to receive from the Government enough money to buy a new car (my choice) every three years. With free insurance, road tax and roadside assistance…
I have chosen not to take this, as it just feels wrong to me to take TOO much!
The list goes on, but I think you get my drift?
My treatment and diagnosis must have cost a low 6 figures (so far)!
I’ve only paid for one thing! That was for a cup of coffee from a dispensing machine in the foyer of the hospital.
It was overpriced and horrible! I think I should sue them!!!
SERIOUSLY
Could I get better treatment in America? Probably/Possibly.
IF I had the money.
Would it be less stressful?
ARE YOU KIDDING???
I want a doctor who sees me as a person in need of help, not a figure on a balance sheet.
When I first realised that you had to arrange for your own health care in the US, I didn’t believe it – thought the person who told me this was joking…..
I AM PUZZLED BY ONE THING, THOUGH
Why does anyone in this country care what the Americans think of the NHS? What difference does it make to us?
This is the country who voted for someone like Bush to govern them, remember? The Global Village Idiot, he was once described as…..
Now they have a President who is intellectually capable of doing the job……. and they still won’t let him help them.
This whole story has made me realise how better off we are with the NHS, than without it.
We should thank them for that…. but other than that, do we really care what they think?
Nicely said. But…
The reason we have to care about what the Americans think (besides correcting misconceptions about our system to help them decide what they want) is that many politicians look to America when deciding what amazing new proposals to push through. Even when they pick a system that has worse average outcomes than the UK’s version (such as public schooling).
It is in our interest not to let ridiculous lies spread too far because certain parts of the media and certain politicians seem to steep themselves so heavily in American output that they can’t tell it from UK output, and don’t realise that most people in the country do not do this. If you want to avoid being fed the lies in 6 months time (despite them being easily disproved by 5 minutes research), it is well to correct them now.
Having said that, this fuss has made it really easy to identify at least one politician that I will never vote for short of ever other candidate proposing genocide. So that’s good.
I’m not going as far into this comment as I would like, but think about where you are. London has the highest population density in all four countries of the UK. Did you expect people not to be overworked? Naive, I think.
If we had the kind of funding for the NHS that the American healthcare system has, it would probably be as good as US private treatment everywhere, but instead there are places like the one you experienced which happen to fall through the cracks. Remember, the NHS runs on half the income that US insurance companies get per year.
Also remember this: if you lost your job in England, you’d have a safety net for healthcare – and basic needs, if you were eligible to receive welfare here. Can you say the same about your beloved US system?
I’m going to twitter this & tell people to not only read the article but the comments. Thank the lord for the truth!
Great post Strawberry! I’m another repat who prefers the NHS to our American system. If you don’t mind I’ll be linking your post to several emails I’ll be sending regarding this very important subject.
Superb, very well balanced post. It is my belief that healthcare here in the UK ranks as some of the fairest and most efficient in the world. Every time I have to see a GP, I can get in within hours usually, sometimes the next day. Dentistry is extremely affordable. Hospital care is superb for the most part and is improving all the time. The UK has substantial problems that need to be sorted out, but it is my firm belief that the NHS is not one of them, and we should all be proud of Aneurin Bevan and his legacy.
I would fight to defend the NHS. I would march in the streets to keep it going and even as a non-affiliated voter, I admire to no end Clement Attlee and Nye Bevan for bringing into existence what can be considered as one of the greatest British achievements ever, and one that went on to revolutionise all of the developed world except the US.
London Mitch. If you dont like your GP or your surgery then change your office. I did. Sometimes you do have to wait until they are accepting new patients. This is exactly like my doctor in the states.
I have found that if you discuss your issues and tell the doctor what you would like done they will do it. I just asked my doctor to forward me to get a mole removed. Not a problems. Just like the HMOs in the states, you have to have a referal to see a specialist.
Dentists are tough on the NHS. It did take me two years to find one. I hold my hand up and say that I waited for a long time to start my search. That said, I could of had an appointment right away if I had gone private.
I have to wonder if you may be in the process of the steps of culture shock. The phase where nothing is good, everything sucks. I was there around year 3. Its a pretty normal place to be. Just make sure that its the actual system, not that you are in a place where you are not happy with anything, before you make a decision. Year 3 was a tough one and I liked nothing here. After nearly 6 yrs I am now content and can see things for what they are. Good and bad.
@butterflyspointofview HMO’s don’t really exist anymore in the US. They were deemed to be a failed experiment. Unfortunately the legislation being debated in the US right now goes right back to the failures of HMO’s by mandating gatekeepers that control the care we receive.
HMOs most definitely do still exist in the US, and they’re quite common. Blue Cross Blue Shield is still organized with HMOs. My health insurance is an HMO, as are the majority of my employed friends.
“HMOs don’t exist in the US” That’s as absured as some of the concervative scare tactics going on. Yes indeed, they DO exist . I’ve been an HMO member since 1984 and in that time I’ve had illnesses, accidents, surgeries, and broken bones, all of which have been covered fully with nary a denial in the bunch. I get excellent care from caring professionals.
As far as the “gatekeeper” comment, are you aware that in order to be accredited, an HMO MUST use clinical criteria based evidence-based data to make decisions? And that only an MD, PharmD, or DPsych can deny any request for a treatment or a service?
What’s wrong with healthcare in the US is the source of payment, not the delivery system. Everyone should have access to the kind of care I’ve had for the past 25 years.
Sorry, Tony, they definitely do. If they didn’t, my job before I moved here wouldn’t have existed–getting doctors onto HMOs’ panels! The go by all sorts of names–HMO, PPO, Hi-ded plan–but there are definitely gatekeepers, and probably more than you even know about.
Butterflyspointofview, I can hardly believe your dismissive reply to LondonMitch.
Culture Shock is not a term to be thrown around loosely, nor is it an experience that follows some sort of schedule. Just because you experienced a culture shock period lasting three years does not mean all or most expats will do the same. I was in the UK for 3 years and I barely experienced culture shock at all.
Suggesting that someone’s valid experiences with the NHS are a result of “culture shock” is, frankly, bullshit. I’m sorry, but it is. Mitch said something you don’t agree with or somehow can’t understand, so your answer is to tell him he’s basically imagining things? That’s nice!
I love England, its my second home, and I’m proud to be dual national. But I do not love England BECAUSE of it’s health care system. In fact, I love it in SPITE of it. I do not account for my distaste and distrust of the NHS because of culture shock, but simply because I had bad experiences. And believe me, I was not imagining things.
Mitch is entitled to his opinions and interpretations of own his experiences.
Sarah,
I guess the reason butterflyspointofview asks about culture shock is because some of the things LondonMitch describes are not true. You can walk into any GPs surgery or local drop-in centre and get seen and you can switch your GP whenever you like. You have the right to an annual check up too. He makes the dentist he visited sound like a medievel torture chamber, which I find incredibly unlikely. Also the NHS focuses much more on preventative care/medicine than does the US system.
Now, it may be the case that he doesn’t know about some of this, as this is not his home country, or because he has been misinformed somewhere down the line. He may even have been unlucky and had a couple of bad experiences, as can happen in any system, unless you are claiming that US healthcare is perfectly run? However bad expereinces are the rare exception, not the rule and he does seem to be viewing the whole system in a very bad light, based on a couple of subjective experiences. Hence the suggestion of culture shock. Butterflyspointofviews’ response was very reasoned and measured. It was your response to his post that was strident and defensive. I’d suggest objectivity next time, rather than just rushing in, headlong.
Thank you for a great, well-written, balanced post. As a US citizen with supposedly “great” healthcare coverage, I still have copays and limits and expensive prescriptions not covered by my insurance, crazy hassles with bills AND no vision or dental.
My fiance has no coverage, so we struggle to find the cheapest option for him, only to be socked by surprised $150+ testing bills that come weeks after we already paid for our visit and tests at the clinic.
And the wait! Are you kidding me? I’ve had to wait months to get an OB/GYN at the numerous different offices I’ve gone to. There’s nothing speedy about our private system.
Thanks again for giving a great basis for my arguments.
I’m a Brit who has spent a few years living in the USA, so I’m seeing this issue from the opposite viewpoint.
I was sent to the USA by a multi-national company and I was fortunate to have comprehensive medical insurance.
What I found in the USA was that there were a lot more checks made on my health, which I don’t think would happen in the UK, and in three years there I spent more time in doctors’ surgeries and in hospital than in the previous 50. I didn’t think there was much difference in the standard of treatment between the two systems.
I have concluded that, if one has health insurance in the USA, then the checks and preventative procedures are more thorough than in the UK. I also concluded that sometimes these checks were unnecessary and were just done to generate fees for medical colleagues.
I don’t know what the situation is for anyone not having health insurance in the USA.
Greg–you’re not really that far off. If you have spectacularly good health care coverage in the US, you’ll USUALLY be well taken care of. (Not always, but that, like any other system, is because some people are better at their jobs than other people.)
The problem, and the debate, is because there are almost 50 million people who have no insurance at all, and no way of getting it. It’s less of an issue for the people who have it already, except that they seem to not want other people to get to have what they have.
I don’t honestly think the US health care system would go to hell in a handbasket if the government paid the bill instead of the people. Heard all kinds of horror stories, but the hospitals and doctors’ offices, unlike the insurance companies’ offices, are really full of people who are devoted, dedicated, and really want to make a difference in the world. I am convinced they’ll be the same good doctors no matter who’s footing the bill.
See, that’s the thing: of course people receiving healthcare in the US are given more checks and preventative procedures. It generates more money for the insurance companies, as you say.
The NHS don’t do a great deal of preventative care before a problem has occurred at all (after is a different matter, but I won’t go into that in this comment), mostly because of their limited funding. Carrying out more procedures doesn’t generate more income for them, it simply uses up more of their assigned budget for any given year.
If we had the kind of budget as far as income goes that the US healthcare system runs on, which is twice what we do have, we probably would get more preventative care in the first instance.
LondonMitch
The NHS dentist side does need sorting out better, but why for someone who prefers Private health care did you not go with a Private dentist?
Also would you love the American system if you was a person who could not afford insurance?
If you could not afford insurance which system do you think you would choose?
Thankyou for putting together this post which covers everything I know to be true about my experience, but explains it a lot better!
I am British but married to an American, and have been living in Massachusetts for 5 years. Like all Brit, I complained about the NHS – kind of a national hobby, like complaining about theweatheror buses.
But to any English people reading this – be proud of your country, because you don’t realise what you have. Yes, the care is great over here, I have a great Doctor, but the treatment, waiting times, availability etc are no different in my experience, and in fact I feel I had more choice about which Doctor I could see back in England, as I didn’t have to consider which was covered by my insurance.
I have heard all of the negative things described in your post over here – many people truly do believe the things that have been said about how we have to see the one Doctor the government dictates, or whatever. People also do not understand that if you choose to, you still can have private insurance, and can take NHS care but pay for some things privately if you wish too. For example, I have had arthritis since the age of 10, and for a period of time my parents decided to pay privately for the blood work I had, and to see a specialist. I could have done this on the NHS but it was a matter of time because I was missing school with hospital visits, whereas it was easier to choose an appropriate time privately. But alongside this, I was still able to use NHS services for everything else, including prescriptions and daily physiotherapy, a therapist visiting my home, and visits to my GP.
I think there are many huge misconceptions about how life is in England over here, not just in this area. I hope, while I am enjoying the many wonderful aspects of American culture, I can help people understand a little more about my own, or at least make them consider there may be two sides to the debate!
Thanks again, I will will passing this on to others, and retweeting it!!
An excellent post!
I’ve already suggested to my husband who is in New York working that he takes himself across the road to News Corp to offer his story of three major abdominal operations and the yearly check ups that he has had on the NHS.
My only gripe with the NHS is that they are/can be extremely selective about what infertility they will treat. In the end we had to go private or else we’d never have had our daughter, however I can’t imagine that had we been in the US it would have been easier or cheaper.
Re. the infertility thing, I have a strong suspicion (as a Brit) that that has to do with our increasing problems with overpopulation and the trouble with budgeting that the NHS has had in recent years. It’s just a thought, though. I couldn’t prove it.
I think it’s really important when talking about either system to keep in mind Strawberry’s point about the fact that an individual’s bad experiences in individual hospitals or doctor’s offices often cause them to form generalisations about the healthcare system as whole:
“… discovered that grumpy receptionists and dirty hospital bathrooms and annoying carparks can happen in any system — because they have nothing to do with the system itself. They’re management issues, human nature issues, and they happen everywhere. And a lot of the fear that Americans have about change in their healthcare actually center around these kind of issues that have nothing to do with the system itself, be it socialised or for-profit.”
My family have personally had some very bad first-hand experiences with the US healthcare system (my own sister is a healthcare worker in the US), but when I first moved to the UK, I still favoured the US system because it was what I knew. I do honestly believe the US hospitals and doctors offer some of the best care in the world, but the price for doing so is just too high. The freedom of not having to worry about my health insurance should I lose my job is incredibly freeing, especially during these tough economic times. I just spent three weeks in the US with family and friends and at least four different people in my close circle made references to having to delay expenditure or job changes because of the costs associate with healthcare. I am so glad I don’t have to worry about my healthcare coverage when making major life decisions anymore… and I wish the same for my family.
I grew up in America and now live in the UK. When I graduated college in the US, I got a job with a successful fortune 500 company. They provide a comprehensive health insurance plan and I could see any doctor I wanted, as long as they were on their list.
The list covered the entire state, but I had to ring 5 different doctors before I found one that would take me on as a patient.
The right wing are presenting American healthcare as some sort of infinitely available utopia where nobody’s treatment is rationed and everyone can choose to go anywhere they list is a big lie.
Yes the NHS is run by the government, and as you say, we can vote the government out of office if we don’t like the way they’re running the NHS.
Americans don’t get to vote against the boards of directors and shareholders of their insurance companies, so they are answerable to nobody as long as they’re making a buck.
butterflyspointofview
I agree with this responce you gave to London Mitch:
“I have to wonder if you may be in the process of the steps of culture shock. The phase where nothing is good, everything sucks. I was there around year 3. Its a pretty normal place to be. Just make sure that its the actual system, not that you are in a place where you are not happy with anything, before you make a decision. Year 3 was a tough one and I liked nothing here. After nearly 6 yrs I am now content and can see things for what they are. Good and bad.”
I have some American acquaintances who live in UK and find absolutely everything wrong with it. They will just never be happy here. And I think because her doctor’s surgery (office) doesn’t have plush carpets, marble columns ….she thinks it’s all not as good.
In the UK I’ve been treated for hyperactive thyroid and also had my gallbladder removed all with top notch care. My hats off to the NHS and I just hope it keeps getting better and better.
Regarding UK dental care. Most of the problems with NHS dental care stem from the fact that the previous Conservative government (roughly equivalent to the Republicans) semi-privatised dentistry, much to the outrage of large sections of the population. This has made it harder to get an NHS dentist. This is NOT a problem with the NHS, quite the opposite. It is a problem with the privatisation of health care. We had a fine dentist, who upon retiring a few years ago sold his share of his joint dental practice to a young dentist recently out of medical school. He was good, provided excellent care, and was completely charming. And pretty soon he was telling us (via letter) that we had a couple of ‘choices’, neither of which involved simply staying the way we were as NHS patients. His ‘choices’ both involved private insurance programmes. We told him we were perfectly happy to stay as NHS patients. He wasn’t happy for us to stay as NHS patients. He forced us out.
Looking back the writing was almost literally on the wall. No sooner had the new dentist taken over the practice than a giant plasma screen appeared in the waiting room bombarding patients with propaganda for expensive and unnecessary cosmetic dentistry. I did an online search on our new dentist and found an old web page he had written while a student talking with great enthusiasm not about how he was looking forward to looking after his future patients, but how he was anticipating making LOTS OF MONEY!!! (and yes, he did write it in capitals with exclamation marks) once he was qualified.
This experience is really my only negative impression regarding the NHS and dentistry, and I must emphasis again, the negativity comes from privatisation and the pursuit of profit over healthcare. Otherwise I have had nothing but good experiences.
I am currently in the early stages of a course of treatment. Last week a capped tooth started to come a little loose. On Saturday night I started to get some discomfort and swelling in my mouth. This got progressively worse on Sunday, and on Monday I rang my dentist’s office and asked for an appointment. I received one for 8.25am the following day. I had an x-ray – the equipment was clean, modern and looked nothing remotely like anything from a torture chamber. I have an infection. My dentist prescribed antibiotics. Once the infection is under control work will begin on the tooth next Tuesday. I will require a total of four appointments, the making of a temporary cap, bridgework and eventually a permanent denture to be fitted in about 6 months when my gum has settled to shape. All this will cost me £198. If I was on social security it would cost me nothing.
My dentist himself is excellent. His assistant, likewise. She is constantly disinfecting and cleaning surfaces. The practice is meticulous about hygiene. I know everything which is being done, when, how and what it will cost. Now like other aspects of the NHS I believe it should be free at the point of delivery. Paying is the only grumble I have, but that is a political matter.
198 GBP for all that dental work? That is still cheap compared to what you would pay in the US (with insurance) for the same procedures! Just getting my wisdom teeth pulled (granted, it was all 4 at the same time) cost me over $900 – with insurance.
I’ve lived in the UK for 8 months and have nothing but good to say of the NHS. I’ve been once to the GP for an ear infection (got in the same day I called, was diagnosed in 10 minutes. Total cost: £7.50 for the prescription), once to A&E for a sprained ankle (<2 hours in the waiting room, total cost: £0) and they have been as good as nagging me to get a pap smear, which I haven't been able to do for nearly 10 years due to lack of insurance in the US. My husband has been receiving treatment for sleep apnea, and all the appointments and referrals as well as his C-PAP machine and his tonsillectomy have been free. We definitely would not be able to afford his treatments if we lived in the US, so he would just have to take his chances with this potentially life-threatening condition. I can't believe that people would rather pay exorbitant amounts to greedy insurance companies, plus copays and deductibles, instead of paying directly for a good system that treats everyone.
I teach English to French students, and the other day in class I had to explain the US health care system to them. The shocked and horrified looks on their faces were a real eye-opener. We are so used to the US system that we don't always realise how exploitative and unfair it is. The US is the only developed country that doesn't offer decent health care to all its citizens. We're not always different because we're rugged individualists, sometimes we're different because we're just wrong.
Wonderful post, I am one who has long been skeptical of the claims about the NHS being a bad thing and I understand why the demogouges in this country use it as a boogieman. It is the ignorance of the population, Americans have for so long been told that we have the best this and the best that; but when you look at what this healthcare system does to the least of our citizens, we should be ashame of ourselves. I have expensiive private insurance and am still restrained from doing much in the way of prevenative care because of the high copays that go with each visit. Co-workers who have used their insurance have been barred from continuing to pay their premiums because the insurance company want their coverage to be dropped thus allowing them not to have to no longer pay for their illness. My mother never was able to get affordable insurance because of her Hypertension. Thanks for allowing us to share in your knowledge of a superior system of health care.
When I read about the American reactions to the prospect of a system comparable to NHS, I was stunned.
I am training to become a doctor and my experiences of the NHS both as a medical student, and a patient are very much positive. Of course, any system has problems, but I feel that to offer quality care FREE at the point of service is a remarkable achievement for our country, and one that I am truly proud of.
I cannot imagine not being able to book as many appointments with my GP as I wanted or needed, not being able to choose the doctor who treats me, or not being allowed to remain in hospital because of the costs. The NHS is there for those who need it most. In Britain, no one will be denied medical care, no matter who they are.
Great post. Thanks!
Wow. Thank you for this post. I’m glad it has either gone or is going viral. I have now given you some link love and some facebook love, in addition to the twitter love. soon you will get some e-mail love and perhaps phone, snail mail, and smoke signal love later after dinner. then we can smoke a cig and eat ice cream.
Thank you for your article, it was very interesting, and has actually left me even more disturbed by the American system than I was before. As you say, it is your own experience, but it seems to me that, on an everyday level (rather than the extreme cases that both sides of the argument prefer to talk about) the NHS provides the most tailored, focussed care.
I suffer from mental illness and behavioural and learning difficulties that affect my organisational skills and ability to concentrate on a task. As a result, I frequently fall behind on my social security paperwork, bank correspondence, bill payments and job applications.
However, the fact that all I have to do is call my doctor and make an appointment, and in some cases all I need to do is turn up at the doctor’s between certain hours in order to be seen, has effectively prevented me from having a nervous breakdown. Just reading about the fact that there is a limit on how many times you can see your doctor in the states made me feel panicky. As for the paperwork…I would have given up at the first hurdle. Having access to my GP and being able to get free prescriptions because I am often too unwell to work is the one thing that has kept me just about on track and off the streets. I don’t know how anyone with mental health problems could possibly manage in the US.
My one experience of an American ER was wonderful. The speediest medical treatment I’ve ever received.
But I’m also aware that between osteogenesis imperfecta, severe chronic sinusitis and a few other medical niggles that I’d be bankrupt if I lived in America. I simply couldn’t afford to buy the 20ish different medications I need.
I hope you don’t mind you’re about to get some HuffingtonPost love…
Hi there,
I would like to just thank you for sharing this with the world, hopefully some people in the US will read it an realise that the NHS does work, and isn’t the burden that many citizens and politicans think it is!
I’m so glad that we have the NHS and don’t think that I could imagine living without it, I don’t see how anyone can be denied the right to health and medical care.
Thanks
(Heads up to Strawberry… JulieB tweeted this, I retweeted, and then my husband retweeted … and loads more have also retweeted.
)
LondonMitch – you are right in that preventative care is given more billing in the US. I should have mentioned that. They have been really proactive with giving blood tests and whatnot for things like vitamin deficiency.
But – I never had a problem finding a NHS dentist. It does very much matter where you live. Thing is, aren’t the majority of dentists in the UK treating *both* NHS and private patients? It is all very confusing, but I could get a checkup and amalgam fillings on NHS rates but a cleaning or ‘nice’ fillings I had to pay private rates.
This is such a fantastic blog entry.
I am really impressed with your honesty about the NHS because no system is perfect and we all know the NHS has been in crisis since the 50s but its the principal of free healthcare from cradle to grave. I don’t like the ugly media coverage coming from the states. Lets hope Hilary Clinton’s sentiments percolate through the White House on these matters.
Keep writing, you’re excellent!
Did you realize that under your heading “I never once received a bill in the UK”, you link to a wikipedia article comparing American and Canadian healthcare?
I’m a wholehearted supporter of the NHS (as a Brit, I should be!) having paid for it through taxes all my working life and am continuing to do so in my retirement. Likewise my wife, who, during our working years, benefitted extensively throughout her three pregnancies. Apart from those, we made little real ‘use’ of the NHS – the odd minor ailment, one broken bone and, with 3 healthy and active children, just the occasional mishap (falling out of a tree, off bikes etc.) was really all the help we needed from the NHS. So, if I was asked 15-20 years ago what I thought of the NHS I’d have had nothing much to say one way or the other.
Until, that is the end of October 1998, when my wife was diagnosed with Breast Cancer. One visit for a (free) mammogram caught it and within 2 weeks, she’d seen two consultants, had a full biopsy of lymphnodes undertaken, had a lumpectomy scheduled and follow-up chemotherapy and radiotherapy arranged, with support nurses (Macmillan) always available to talk with and get advice from whenever it was needed. By mid-December the operation was completed and she was at home for Christmas and the course of chemo- and radio-therapies completed by Easter. All with NO DELAY, for NO CHARGE, NO CLAIMS, NO FINANCIAL CONSIDERATION and bags of SUPPORT, including twice-yearly visits to both Oncologist and Surgeon/Consultant. That continued for 10 years when another regular mammogram indicated the possibility of the cancer returning, and, once again, the NHS responded with full support, including hospitalisation and follow-up treatments without delay or COST to the patient (i.e. us).
For me, the NHS came to my rescue when I went down with pneumonia and complications, including heart problems and these were treated quickly, competently and with no fuss or cost!
SO, I’m proud and grateful to our NHS – to my mind it compares favourably with our one experience of the US Medical ’service’ which billed me $2400 (covered by holiday insurance) when my wife fainted in a Dearborn restaurant and was taken by paramedic to a local hospital for treatment (and sent back to our hotel within 2 hours!) – demanding payment or evidence of insurance before a doctor could be CALLED!! I dread to think what the bill would be if one’s really ill!! If that was typical of the US heatlhcare service then ……………….I’m lost for words.
So, Mr and Mrs America, don’t knock our “service” – it’s not perfect but it works and it’s free at the point of delivery to everyone in the UK. That’s everyone, not just those who have healthcare insurance and whose treatment is goverened by cost as opposed to need.
I am also an Englishman living in America, with my American wife. Briefly after arriving, when my wife had lost her health insurance, I had to visit the emergency room.
This experience emphasised to me just how good the NHS was, and how I had taken it for granted.
Health care should not be a privilege, and those fighting against it seem to be middle class, well off and to have never had to deal with any issues affording the high premiums.
It seems like a sprinkle (or a truckload) of compassion is required to show these people the light.
I just hope that common sense prevails and the voice of the majority is actually heard over the insurance lobbyists and minority of vocal opponents.
I am a Brit. I lived all my life in the UK until 2 years ago. I’m now in the US.
Having gone through the visa process and been active on many messageboards pertaining to that, this argument is a frequent and tiresome one. The one thing that the author states that I agree with is that you cannot hear individual’s tales and base your decision on those as you are only getting part of the story.
I object to the use of the term “free (at point of delivery)”. In other words it is finally being acknowledged that iit is NOT free. By the same careful use of words I could say that the US healthcare is free (at point of delivery) except for a small co-pay. However the difference in quality, waiting time and aftercare means that I would happily pay that co-pay. Besides which prescriptions still have a charge.
There are many issues that I have an alternate view on in this article and i have had the battle so many times I am now indifferent to the battle. US citizens. Do as you will. Reap the “benefits” and deal with it afterwards. I believe the cons far outway the pros in the NHS Vs US Healthcare argument.
Whilst I appreciate your views, they do make me think that you are a healthy individual living in the US. Get a serious illness and you will soon find that all those small co-pays and deductibles and out of pocket expenses soon mount up too. However, it’s a great system for the healthy and covered. but you aren’t the reason that healthcare reform is underway; it’s for the Americans who are uninsured because they can’t afford it, have pre-existing medical conditions which prevent them getting coverage, for the ones who have bankrupted themselves to pay for care of themselves or loved ones once they have maxed out on their plan, for the ones who are covered but the coverage proves to be inadequate when they need it.
Well said, Amanda, thank you.
Folks, I am absolutely overwhelmed by the response to this post. This was only an email I sent to my mum’s friend, and then I cleaned it up a bit and posted it here. Thousands of hits later, I find myself absolutely gobsmacked at the result.
I am so grateful to you all for your comments and for the incredibly kind things you’ve said about my writing. It has truly had me on a high all day.
When there were only five comments, I thought, “I must reply to each of these people…” but then the kids began fighting and I got sidetracked. Then when it was up to fifteen, I thought, “I really must reply…”, but never got the chance. Now it is up over fifty comments, there is no way I could reply to them all.
So let me just say one big thank you to you all. And a special thank you to those American expats who have shared their own experiences and feelings on the subject. And thank you also to everyone who has linked to this post, tweeted it, Facebooked it, or otherwise told others about it. It’s been incredible to watch the traffic pouring in!
There are a few comments in particular, though, that I would really like to reply to, and I will take the time shortly to do that. In the meantime, however, one of the kids has just chucked her dinner on the dining room floor, so must dash…
Please tweet Obama – he really needs to promote the views of people like yourself who have experience of both systems.
Thank you for this scrupulously fair and honest post!
Seems to me that all the people singing the unwavering praises with 100% support of the NHS are the people who base that on their own individual success stories.
I am aware that the NHS is effective in many cases. In “general” it has more cons than the US system which is also flawed.
Strawberry, your article seems to be doing the rounds, and justifiably so, it is an excellent description of your personal experience and insight into both systems.
When I’m talking to my American friends about the NHS I usually draw a comparison with the Tennessee Valley Authority. It’s not so much about the details about whether or not it works, or whether it could be reformed or privatized, but because it invokes a kind of regional (or national) pride and woe-betide any politician who makes the mistake of talking about interfering it in public (a la Barry Goldwater). This national pride that we have for the NHS may sometimes make us overlook some of the things about the system that could be fixed. On the other hand, I love watching how all sides of the political spectrum here in the UK, left and right, rallying around the NHS, describing their own experiences of how it benefitted them. The stories of Gordon Brown, David Cameron and Stephen Hawking about how they or their families would be worse off without the NHS resonate right across the country. People here have taken the assault on the NHS by the American right very personally, and as your article and many of the comments above show, anyone who has been here and used the system can see why this is so.
In fairness, I think that there are parts of your article that might be slightly too overdone in praise. The obvious observation is the controversy over Herceptin. Herceptin was originally denied on the NHS because the evidence that it was effective was not especially compelling (the NHS, just like the lower-end insurance companies in the US, will not pay for some whacky new wonder drug until they have seen some proof that it works reliably).
The reversal of this judgement was taken on a political basis, not a medical basis, and from that point of view it could be argued that money within the NHS was allocated not on the basis of medical effectiveness and value, but on the basis of who was able to campaign and shout the loudest; and thus, money was misallocated. Of course, when it all boils down, I would rather take the risk of this happening than take the risk that my doctor is prescribing a useless drug because he is being paid a commission by the pharmaceutical company for doing so – something which is common practice in the US. But we mustn’t kid ourselves about the issues that can arise.
Another minor detail – and I am being picky here – is that you will eventually get into trouble if you’re a hypochondriac visiting the doctor every day. There was controversy a few years ago over people getting “struck off” for constantly bothering their GP surgery all the time. This, of course, happens to Americans with their insurance companies too, but I think it’s important that people see it isn’t a take-whatever-you-want free for all. Eventually you will hit a point where they will say “look, you have been visiting the doctor every day for the past three weeks even though you’re not sick. This must stop or we’ll remove you from the list”.
There have also been changes to correct the problem where people from abroad were coming to the UK to avail of the free healthcare. As you noted yourself, the hospitals simply had no concept of how to bill somebody for care if they were not UK taxpayers. The hospitals and doctor’s surgeries did not have billing offices or credit card machines. Either way, they did not care, it was not their job to send people a bill. Supposedly, this is no longer the case anymore and people from abroad are expected to be properly insured if they are sick when they are here.
Lisa – prescription charges have been abolished in some parts of the UK. So now you’ll get your prescription drugs at no cost at all. This was always the case if you were a minor, or were on welfare or incapacity benefit.
Overall, I love the NHS and everyone I know feels the same way. I love being able to call the doctor and ask him to visit my house on the rare occasions I’m so badly laid up that I can barely get out of bed. I like not having to pay bills, and knowing that if I do get really sick one day – well, the wallpaper in the hospital might be a bit grotty but I’ll be treated – perhaps not to Beverly Hill standards, but to an extent that ensures that I’ve a better chance of living longer than the average American does today.
ChasUK, the term “free at the point of use” was coined when the NHS was first created in 1948. It is not a new term designed to somehow cover up the fact that the NHS costs money. Everyone knows it costs money, and people are happy to pay it. Moreover, as Strawberry pointed out quite correctly, that the UK people gave the Labour government a very clear mandate to increase National Insurance contributions with the specific purpose of improving funding into the NHS, thus (hopefully) improving the level of service.
I think the system in the USA works very well provided you are with an employer who has a good insurance scheme. It sounds to me as if you learn the hard way when you go to change jobs and find that your new employer doesn’t have such a good scheme – or even has a scheme based on the dreaded HMOs. Or worse, there’s a gap between your old and new jobs, during which you and your family are not covered.
In the last quarter century my mother received excellent NHS care for two heart attacks. She had time in Intensive Care and numerous district nurse and GP home visits. More followed when she had to have her gallbladder removed. She had cataract surgery on both eyes. Later she had pacemaker surgery. In her last years she had excellent home support for angina, including regular district nurse visits for check-ups and blood tests, and also for Alzhiemers. She also received very good support for her hearing problems, including the tests for and fitting and supply of hearing aids. Replacement batteries were supplied free by the NHS. Countless GP, consultant and outpatient visits were paid for out of general taxation. If our family had had to pay for all of this we would have been living on the street, or else my mother would have died 23 years before she did. That’s the plain and simple truth.
I could tell a comparable story about my father’s last two decades. I’ve had my own share of health problems, which have resulted in surgery three times in the last 12 months. Without the NHS I dread to think what might have happened to me. My wife equally has had several serious health problems resolved by the NHS over the past few years, all to our complete satisfaction. Such treatment can even save the state money (which of course is ultimately our money), enabling people to return to work and once more pay taxes and contribute usefully to society when otherwise they would be unable to work and probably have to subsist by claiming social security benefits.
I have seen the NHS improve greatly in recent years. It went through a bad patch during the long dark years of the last Conservative administration. These were the ‘greed is good’ years of Margaret Thatcher and then later John Major. It is not surprising that during this time the NHS was particularly underfunded given that Mrs Thatcher famously declared that there is ‘no such thing as society’. Faults in this period with the NHS can often to be traced to underfunding by a government diametrically opposed to the organisation’s very existence.
Clearly there are people argue that those who can’t pay shouldn’t expect others to fund their care out of taxation. What that amounts to, though they would not be honest enough to say it, is pay or die. Pure Darwinian survival of the fittest. I’m alright Jack and I’m not going to give one penny to see you are. This is a brutal, one might argue sociopathic view. It certainly lacks civilised human empathy. I believe it is an outlook which – I’m not going to go into details, you can believe me or not – killed my mother-in-law. Yes, George Bush’s ‘reforms’ (i.e. changes to allow private insurance companies to make more profits) of the Medicaid / Medicare system killed my mother-in-law. If the system had not been ‘reformed’ into the hands of the insurance companies, or if America had an NHS along UK lines I think there is a very good chance my mother-in-law would be alive today. Because she would not have been denied the essential medication she was up until that point receiving. She would also most likely be in much better health than she was in her last few years in the US.
It astonishes me that so many of the most vociferous and vitriolic opponents of healthcare reform in the US argue the way they do from what they maintain are Christian principles. Fortunately it is no form of Christianity recognised in Europe. When I think of the difference in treatment my mother and my mother-in-law received on different sides of the Atlantic I know which side seems the most Christ-like to me. Which system is the most humane and compassionate, and should you so accept it in its caring for all regardless of any consideration other than that of health and need, essentially true to the real spirit of Christianity.
London Mitch — Thanks for your perspective. In some ways, you’ve made exactly my point for me. Specifically, with your trouble finding a GP… I note you are in West London, a highly populated area of one of the biggest, busiest cities in the world. I suspect that it might be that fact which is more of a factor in your problem. If it were a problem caused by the system, then it would be a problem everywhere. The fact that it isn’t lends credence to the probability that — like a dirty hospital, like a grumpy receptionist — it’s a localised issue not directly caused by the choice of overall healthcare model. This is one of the major points I was trying to make.
And again, where you compare it to schools, the fact that a person can move to an area with good healthcare shows that it can be done under the NHS model. The failure is not that of the overall system, but of that particular local trust. The difference with schools, of course, is that whereever you move in both countries you have a right to access state-funded education, whereas in the US, you may not be able to access affordable healthcare no matter where you move (due to pre-existings or cost).
Regarding your delays, I’m sorry you had to experience them. Of course, you could have skipped the queue and gone to a physiotherapist at any point you wanted by using the time-honoured capitalist method of paying for it by yourself.
I’m not saying that you should have done that, but the belief that you can’t is one of the misconceptions about the NHS.
I wonder also if your private insurance is simply not a very good policy? I have had several different types of private insurance coverage in the UK and, to be honest, they all sounded better than what you described. If so, you are simply experiencing in the UK what so often happens under the US system — being underinsured. There are millions in the US in the same predicament, but without the comfort you have of knowing that what their insurance doesn’t cover will still be taken care of by the state-system.
Regarding preventative care, I think it depends on what you choose to look at. Yes, you’re absolutely right when you say that NHS GPs do not conduct annual check-ups — and that is certainly less preventative than in the US. On other hand, I am absolutely right when I say that the pro-active post-natal home-visits that I received from midwives and Heath Visitors is extremely prevention-focused — much much more so than anything most people get in the US. So it’s horses for courses, different ways of doing things and different things that people are used to and expect. At the end of the day, if you really want your annual check-up, you can certainly get one privately — I seem to recall that many of the major insurance companies are very big on those sorts of preventative measures.
At the end of the day, it sounds very much from your comment that you are coming at this from the position of someone who has always experienced American healthcare cushioned by good insurance — just as I was before I moved back to the US (I could be wrong, but that’s how it sounds). When you compare the NHS to American healthcare in that way, I think the NHS does fall short. But when you take the American situation as a whole — the people with gold-plated insurance policies, the ones with merely adequate policies, the underinsured, the uninsured, the people who will lose their insurance because of illness or job-loss or impossible cost — the comparison looks very, very different indeed.
Comrade Stalin — Thanks for your comments.
Regarding Herceptin, that was exactly the very point I was making: that because the NHS is government-run and health issues can become political, the people have the chance to make the changes they want (for good or for ill) if they make their voices heard. Whether approving Herceptin was the right decision or not is irrelevant — the fact is, the people got the change they wanted. Here in the US, the people are much more powerless against the insurance and pharmaceutical companies that run the healthcare industry — it is their voices who are heard, much more so than the people’s.
Regarding hypochondriacs and health-tourists… yes, I know I didn’t touch on those issues but that’s because they are really something of a side-issue. The NHS does have to deal with and they may be prevented from accessing all the care they want, but that does not change at all the fact that the NHS provides care to every legitimate resident for their real (actual) medical needs, across the board.
Never mind–I see you are linking to a specific chart on Wikipedia that includes all the G8 countries. Very interesting!
I agree with all you have said here, Strawberry. I too have experienced both systems.
I was given excellent care in the UK under NHS: I had a panic attack and went to my GP, who sent me to the hospital for testing. I’m sure they knew immediately that I was having a panic attack, but they gave me real, comprehensive care. I was given oxygen, an EEG reading, a chest X-Ray, blood tests, and stayed overnight. My results were back the next day. After this I went to talk to a counselor about why I had a panic attack–she was able to see me within two days. I’ll always be grateful.
It’s absolutely true to say that you can have good experiences and bad experiences in either system. I, friends, and loved ones have waited just as long for appointments, specialists, or tests in the US as friends in the UK. My grandfather had to wait about 6 weeks for his doctor in Florida to send his medical information to his doctor in Ohio–in the meantime, he had an open cancerous ulcer on his leg going untreated (we needed the records to determine if he could get radiation or not). Then again, I had surgery here in the US that was scheduled quickly and efficiently and was carried out flawlessly. My doctor was fantastic, I was very lucky.
Given a choice between the two, having experienced medical care under NHS, I would choose it again in a hot minute over the system we have in the US. Mostly what I remember was the feeling of relief, the lifting of the oppressive burden of constant worry that getting sick or, god forbid, getting REALLY sick would basically dictate your finances for the rest of your life. I would gladly pay more in taxes to have that feeling in the US and to give that feeling to my fellow citizens.
I want to add that we, the patients, often overlook our own part in the quality of care we receive. The operation I mentioned above was a hysterectomy. I have heard and read so many negative experiences of women who got one but went into the operation un- or underinformed. I was stunned when I read blog or message board posts from women that said things like “I didn’t know the doctor was going to take out my ovaries!” or “they didn’t tell me I would be on estrogen after the surgery!” I just think–didn’t you ASK? I sure did! Someone was going to open me up and get intimate with my internal organs–I made darned sure I knew EXACTLY what they were going to be doing! Great, fabulous healthcare probably isn’t going to be handed to you in either system. I find that most of the time if I want quality care I have to take an active role in pursuing it.
I’ve lived in Europe for 25 years, 12 of them (1980-1992) in Britain. I was actively involved in support for the NHS during the Thatcher years, when there were misguided efforts to privatize it. I think one has to be very cautious about saying it’s “socialist,” since it never went that far and always had elements of private health care within it. But, it is truly a model for the rest of the world. No one is excluded because of ability to pay; it is truly free at the point of use. And it is supported by Britons regardless of their political affiliations. For those concerned about such things, it has never threatened the nature of capitalism in Britain. It is just testimony to what a fair-minded society really must do.
I am a British expat living in the US for the last 15 years and I SO WISH EVERY AMERICAN WOULD READ YOUR POST.
The fear and hyperbole over the US debate here is getting out of control.
And thank you for nailing it on the head – I DO believe that health care is a basic human right. I think it’s a matter of compassion and we’re seriously lacking some of that out here in the debate right now.
Interesting reading – i think this might go viral, I was directed here from a travel website.
London Mitch
It sounds like you have a crap GP. I had one of those in London, I changed within a week. Register with a different GP – even it is a bit further away, or keep calling the other surgeries – people move all the time in London so although the list may be full it will have vacancies at some time.
You also have the option of using a walk in centre or a private GP.
Oh and the reason for Dr’s specifying you need to live in a particular location to be on their list is because they make home visits, not just the Dr but the nurses as well in some cases.
Your Dr can refer you for physiotherapy – mine does. Your Dr can also refer you (and your wife) to any NHS hospital you choose. You have a right to that in law – use it.
Or you could have gone privately and paid £30 ish. Or if you had private insurance (not sure what the company thing you are talking about is – sounds daft) you could have paid nothing to see a physio.
There is no such thing as a copay – you are talking about a prescription charge. Your wife being pregnant will not pay it and she will also get entirely free dental care (OK not cosmetic but that’s not really a necessity).
You also have the optin of paying
Prescription charges don’t apply in Scotland or Wales, to anyone under 19 if they are in education, to people on low incomes, to people over 60, to people with certain medical conditions.
Also if your wife is taking regular meds she has the option of prepayment (3 month or annual) so she can pay £100 and not pay a penny more for her prescriptions for 12 months.
You are wrong about preventative care. You can have the blood and urine tests at any time. Most surgeries also run ‘well woman’ and ‘well man’ clinics. Admittedly most brits don’t bother.
There is also routine screening for bowel cancer (over 50’s), breast cancer and smear tests.
Now there seems to be a rumour that you can;t have a smear in the UK until you are 25 – not true. The age for routine screening is 25 – that’s when you start to get the letter in the post but if you go to your GP for contraception (which is free) you will be offered a smear. If you have any gyn problems you will get a smear. I know of one teenager who is getting smear tests every 3 months – lots of gyn issues.
I’m puzzled. If you prefer the American system why have you not taken out private medical insurance? I’m guessing from what you have said you are 30ish and if you have no medical issues you could get cover for about £1000 a year.
Sash, I’d love it if it went viral — I so want America to get some reason and balance in this debate! Please, everyone, feel free to tweet/link/Facebook this.
What travel website did you find it on?
Word.
I had my first smear when I was seventeen, because I was suffering from periods so heavy they put me very close to becoming anaemic. If you have any gynaecological problems and go to the doctor, you can get a smear test no matter how old you are (though under-16s have to get parental permission and usually have the parent – preferably female in most cases – present).
I don’t understand the misconception that if you are working and earning that you cannot go private if unhappy with NHS service. I really don’t.
ChasUK — thanks for your comments. Interesting points.
I have to disagree with you where you say “US healthcare is free (at point of delivery) except for a small co-pay”. I assume you’re talking about the amount you pay up-front to the receptionist when you go to the doctor’s office? Yes, that is small, usually in the region of $5-$30. But most insurance policies also have a deductible (an amount that you have to meet annually before the insurance kicks in, ranging from several hundreds to many thousands of dollars). And then once the insurance does start paying, most policies also have a co-pay amount that the patient must pay (the most common being an 80/20 split of the bill) until he finally reaches the max-out-of-pocket amount which, again, is usually in the thousands. And all this is on top of the monthly premiums he pays, the amount his employer pays (which actually results in/comes from his lowered wages), and the amount he pays in taxes to support the 47% of the country’s healthcare bill that is ultimately paid by the government (source: the Economist, but damned if I can find the article now!). When we say that the NHS is “free at the point of use”, we mean that no money changes hands to use the service (other than capped prescription charges and, of course, the taxes that support the system). Compared to the amount of money that changes hands in the US system, it would be a HUGE stretch to suggest it is anything like “free at the point of use”.
Regarding your comment that “Seems to me that all the people singing the unwavering praises with 100% support of the NHS are the people who base that on their own individual success stories”… I agree. And it seems that there are an awful lot of them. Certainly they form the majority of Brits I know, the majority of American expats I know, and the majority of American expats who have posted here. Conversely, it also seems that all the people singing the unwavering praises with 100% support of the American system are people who are lucky enough to have very very good insurance policies. The millions who are not in that very privileged position often seem to have a very different opinion.
Thank you so much for writing this blog! I too have lived in the UK and took advantage of the services the NHS offers. I never had to pay a penny for any service. They didn’t even look at me funny for having an American accent. The only thing I ever paid for was prescriptions, and EVERY prescription WAS THE SAME PRICE (for a 30 day supply)! Not only that, but, many generics are available there that we simply cannot get here (because pharmaceutical companies are allowed to patent their drugs under their “designer names”).
The only problem I ever saw with the system is the MRSA outbreaks in the hospitals. At the time it was all over the news and papers every day, but that’s what the media tends to do–hype things up. I’m not saying it wasn’t a problem, and maybe it still is, but I think you are right in saying that that is a MANAGEMENT problem. The hospital staff wasn’t being trained to properly clean or perhaps they aren’t given the proper supplies. You can’t necessarily blame the whole of the NHS for that problem. The system works for millions of people.
Given the choice again, I’d take the NHS because I always got the care I needed. I currently do not have health insurance and it scares me to death. Pardon the pun.
MRSA is a problem here in the US too. So, yes, not limited to one system or the other, not eliminated by choosing one system over the other.
Well there is a strong argument that issues like MRSA have been made worse by the increased use of the private sector within the NHS.
Cleaners/maintanance used to be employed by the NHS, i.e cleaners employed by a specific hospital , whereas now contracts have been outsourced to private companies.
They bid for contracts and provide services a wide number of hospitals. It could be a different cleaner everyday. So whereas before a matron had the power to maintain standards on their own wards, now they don’t.
So ironically the charge of too much bureaucracy within the NHS has largely been increased by private involvement
I looked up this info a few days ago for someone so I have it to hand Lisa. The UK HAI (hospital acquired infection) rates seem to be lower than the UK ones nowadays
UK HAI rate 7.6% http://bit.ly/CAzs8
US HAI rate 10% http://bit.ly/2aegk
The link to the US rates is to a wikipedia article but there is a ref in that to the original source for you to check out the figures.
Anyone who claims there is ’superior’ health care available in the US has a screw loose. Also: comparing ’systems’ in the UK and the US is futile – there is by definition no system in the US.
This health care business is actually very simple. It shouldn’t need a patronising four thousand article to explain it.
I thought it might be interesting to add to the discussion a short piece I wrote a month ago on my website (theporcupine.org):
Wishes For a Renewed Vision of Medicine
If we win the fight for a real national health system, a single-payer program, in the United States, it will signal the beginning of something even more significant than just the way we pay for or allocate health services. It will signify a step toward the reinventing of medicine in this country, of restoring its proper role as a healing art, as a way to achieve social justice. There are a significant number of doctors who already see this as the ultimate goal and they are deeply engaged in the struggle for health-care reform precisely because they want to practice medicine in that way, to fulfill a basic human need, not to make a profit. It works. I’ve been fortunate to have lived in Britain for 12 years, to have collaborated with doctors, midwives and public health workers, to have experienced this vision of medicine first hand. It is from this experience and engagement, as much as from principle, that I want to see it become the norm here.
Moving to Bayswater.
Twenty-five years ago, at the height of British Prime Minister Margaret Thatcher’s brutal assault on her country’s working class, on trade unions, on basic social and political liberties, my wife and I moved into a one-bedroom apartment in the central London district of Bayswater. It was an incredibly diverse area, both ethnically and economically. Just to the east was St. Mary’s Hospital, where Alexander Fleming had discovered penicillin in 1928. Just to the west was Notting Hill, the site of the annual Carnival that has become the largest festival of its kind in Europe. (U.S. audiences, of course, are more apt to know the area from a 1999 film with Julia Roberts and Hugh Grant.)
When we moved to Bayswater, it was an area of immense social contradictions. There were the obvious signs of gentrification. But, the area also bore the brunt of Thatcherite policies that were affecting the entire city. London’s working-class, immigrant and native-born, was suffering from government efforts to restructure the economy, to make it more profitable for a few, that, in the process, drove the national unemployment rate up to past three million by 1982, triple what it had been a decade earlier. Equal to almost two-thirds of the population of Finland, the poor in Britain were literally a country within a country. For London’s poor, it was increasingly difficult, not just to find work, but to find shelter.
According to the New York Times in late October, 1987, “Homelessness and street squatters are on the rise…as the construction of housing for the London poor has fallen from an average of more than 20,000 units a year in the 1970’s to little more than 1,000 lately because of the Thatcher Government’s cutting local capital borrowing authority by two-thirds.” The response of many of the city’s boroughs was to lodge families temporarily –though this might last years– in bed-and-breakfast accommodation. As the article explained: “The housing of the poor in seemingly quaint B. and B.’s – a tucking away of desperation amid the faded antimacassars of an earlier age – is the fastest growing and most expensive new welfare development occurring in Britain.”
By the time we arrived in Bayswater, the area’s bed-and-breakfasts had become one of the chief repositories for homeless families from other parts of London. As such, many of the people on the streets, in the buildings, around us, suffered from the health and educational problems that typically afflict people living in such conditions. Inevitably, this stirred political activists, among whom were socially conscious physicians who realized that there could be no normal medical solutions, no easy palliatives to be prescribed, for health problems created by national political and economic policies. As Wendy Farrant and Angela Taft of the Department of Community Medicine, St. Mary’s Hospital, wrote in Health Promotion International in 1988: “The major determinants of ill health (such as poverty, poor housing, homelessness and unemployment) lie outside the traditional remit of the health sector, and certainly cannot be solved at a purely local level. Many of these problems can be related to national policies that reinforce the health divide. They are exacerbated by local government policies that are damaging to the health of the more disadvantaged sections of the population.”
Writing specifically of the situation that had emerged in Bayswater, The British Medical Journal reported: “Living in a bed and breakfast hotel is not an extended luxury holiday. It means keeping all of your belongings in one room, living out of suitcases, and giving no privacy. Children are born and brought up in one room, where they live with the rest of their family. There is no safe place to play. Washing and cooking facilities are shared with other families, and there may be nowhere to store food…The adverse effects of these conditions on health have been well documented.”
It was in response to these health problems created by the Conservative Party’s political and economic strategies that the Bayswater Hotel Homeless Project was created “to cater specifically for homeless families but to ensure that they have all the benefits of registration with a local doctor. The project pays local general practitioners for sessions at a special surgery. When a family attends it is temporarily registered with the doctor on duty, and after three months permanent registration is arranged.” One of the leading figures in the Bayswater Hotel Homeless Project was Dr. Richard Stone.
Meeting Dr. Richard Stone.
As it happened, one of the first things we had to do after moving in to the area was to register with a doctor. (Quite the contrary to what people in the States imagine about how the British National Health System worked, this was entirely our decision.) We walked around the area, visiting different practices, until we came across one that felt right. It was run by Richard Stone, along with four other doctors. Stone, of Lithuanian Jewish background, was an exceptional physician, unencumbered by a narrow or reductionist sense of what health care required. What impressed me was that his views, consciously or not, owed so much to a tradition that had originated in the mid-nineteenth century, of which one of the most impressive and influential figures was an old hero of mine, the German pathologist and anthropologist, Rudolf Carl Virchow, one of the giants of what is now called “social medicine.” Up until his death in 1902, Virchow maintained that “Medicine is a social science and politics is nothing else but medicine on a large scale.”
As Western medicine during his momentous lifetime was steadily professionalized within the capitalist marketplace, Virchow’s view was increasingly discounted, but never entirely silenced. It has always remained the view of a significant number of progressive physicians who regarded that moral vision of medicine as a vital and necessary part of the process of progressive social change. In Britain, in the decades between the two world wars, it was a vision that was kept alive by doctors such as Scottish-born A. J. Cronin who studied medicine before and just after the First World War. In the twenties, he briefly practiced in Tredegar, a mining town in South Wales that was the birth-place of Nye Bevan who, two decades later, would be one of the chief architects of the National Health Service. Cronin eventually moved to London, where he practiced in Harley Street, before establishing a less lucrative surgery in Bayswater.
Given the prevailing realities of health in Western society, good doctors have often felt compelled to move beyond medicine in the conventional sense. So it was with Cronin. In the 1930s, he turned to writing novels that expressed his conviction that medicine should be an instrument of social justice. The most famous were The Stars Look Down (1935) and The Citadel (1937), one of the most popular British novels of that decade and one that has been credited as one of the inspirations for the NHS. As it was for Cronin, it was for Richard Stone. When he was in his office, he treated his patients with understanding and patience. He never regarded a pill as the ultimate answer to someone’s problems. So, we often saw him on the evening news, on a picket line, protesting the consequences of Thatcher’s policies.
I feel that we were deeply privileged. Sitting in the waiting-room of Richard Stone’s five-doctor practice a quarter century ago, what you immediately noticed were the large photographs on the walls. They were stills from the great 1938 film, The Citadel, based on the Cronin novel. Most of them featured one of my favorite actors, Robert Donat, as Dr. Andrew Manson. The book and the movie tell the story of a journey from his early practice in a Welsh mining village (much like Tredegar) to the point where he abandons a lucrative London practice to set up a multi-doctor clinic in a small town. Cronin, of course, established his practice in Bayswater and the pictures were hanging on the waiting-room walls because Stone’s practice was, in fact, the actual descendant of A. J. Cronin’s. We had somehow found our way into an important piece in the story of what is best in Western medicine, what I hope it will be like some day throughout the United States. Establishing a single-payer system is essential, but it is just the beginning. There will still be much to do.
I have been extremely skeptical about the thought of universal healthcare. My infant son was recently diagnosed with type 1 diabetes, and I was afraid of what it could mean for his future care. I was worried that he would have to give up his insulin pump, or not be able to get a new one when the time comes. Honestly, I am still a little worried about that. BUT, when diagnosed I was working and had decent insurance. His hospital stay was only $1500.00 per day, his visits to his endocrinologist were $50, and his prescriptions ran about $300/month with copays. With his diagnosis, I have had to leave my job because being an infant his care is very intense and overwhelming. Now we are on my husbands insurance. he works for the state government. I recently got our first dr. bill and it was over $400. The insets for his insulin pump cost over $125/month and prescriptions now run about $50/month. Our insurance costs us over $350/month, is the best plan that is offered in our area, and provides NO coverage until we have paid out $2000 per person or $5000 per family. Also, we have to drive over 8 hours to get to his endocrinologist because there are no doctors qualified to treat an infant near us.
And for the fact that there is more preventative care, that is only if you can afford to go to the doctor. Even with insurance the rest of my family (other than diabetic son) avoid going to the doctor because, even with an upper middle class income, we can’t afford it.
While I am still nervous about universal healthcare because we see the government screwing up so many things, I also feel like they can’t do any worse than the insurance companies. It seems to me that both system have similar flaws, but at least with universal healthcare I wouldn’t have to be considering a mortgage on my home to keep my son alive.
Chammond
Under the UK system your son would get all his car covered for life. His pumps, strips and prescriptions would be free as he is diabetic. He would see speicalist. I just saw an endocinologist a few weeks back and they ran a million tests. None of which cost me a thing.
My nephew in the states is type 1. My worry for him is that in a couple of years he will be to old to be on his parents insurance. I dont know how he will get coverage if he cant find a job that has top notch insurance. He has a pre-existing conditions and I fear what how he would afford to pay for his insulin without insurance. The thought of choosing between his medicine or rent is a horrible though. What is really sad is that so many people are already in that position.
Chammond, as a Brit I find your situation genuinely shocking, this is why I & many of my fellow Brits have been rushing to defend the NHS against the recent smear campaign.
If you were British, your child would get absolutely everything he needs, free of charge, regardless of your income, full stop.
All that money & you have to drive 8 hours to see a specialist!? You can drive the length of Britain in less time than that.
Truly horrific
“Only” $1500 per day for a stay in hospital?
That’s shocking, really. That’s a third of my annual income!
I had written a reply back when there was only one comment and had decided not to post. Now, having read so many unopposed praises of the NHS, I feel its my duty to chime in. And I will try to do so as briefly and concisely as possible.
Like LondonMitch, my experiences with the NHS as an American living in England were deplorable. UNLIKE LondonMitch, and counter to Strawberry’s suggestion that location makes all the difference, I lived in a quiet little ex-mining town in the Midlands which was served entirely by a relatively well-to-do town in which blue collar workers live in close proximity to celebrities and national athletes. The town was small, not over crowded, and well served. However, the medical care both my husband and I received in the three years we lived there was beyond incompetent. Location had nothing to do with it. Instead, the doctors in our clinic were simply not paid enough to give a shit.
It was not until we moved to the US and found a new doctor that we were finally diagnosed with the issues which had been ailing us in the UK. For me it was Migraines (my sorry excuse for a GP couldn’t even diagnose classic signs of migraine – not a difficult feat for even a moderately competent doctor!). For my husband it was Diabetes. His complaints were also classic Diabetes symptoms, and yet our GP had not even thought to perform a simple, dirt cheap blood glucose test with a hand held monitor and a single lancet. We TRUSTED our GP. We were annoyed at his lack of proactiveness, but trusted that if he thought it was “nothing” (his words), that it probably “nothing.’ Unfortunately, our trust in our GP caused my husband to go from what was probably pre-diabetes at the time, to full blown diabetes in the course of just a couple of years.
Now, my husband is uninsurable except through employer provided insurance or high-risk health pools, and life insurance costs an arm and a leg. This could have been prevented if only our GP had thought JUST TO CHECK.
A SIMPLE BLOOD GLUCOSE TEST that costs NOTHING but a small plastic lancet and an alcohol swab. 20 Seconds, MAX.
Perhaps the saddest story of NHS failure I have ever heard involved my husband’s own mother. Upon visiting her GP for strange symptoms she was told that she was suffering from mere “stress”. Her GPs thought nothing of it, did no testing, and told her to take it easy. Her symptoms mounted over 15 years and after several repeat diagnoses of “stress”, she was finally so poorly that she went in to hospital where they FINALLY diagnosed her with CANCER. By then it was too late. She had excellent surgeons and later, equally as great cancer treatment at a specialist hospital. But it was not enough to save her or significantly curtail the illness. 2 years after her diagnosis in hospital, she died. It was the persistent negligence of NHS GPs, over a period of 10-15 years, that probably caused her cancer to be unbeatable. Its likely she could have been helped, might have survived, at least given at a few more good years, if only her doctors had LISTENED!
I should note that she also lived in a small well-to-do town where medical care, by Strawberry’s argument, should have been wildly available, unstressed, and generally ‘better.’
As for me, my care should have been simple in comparison. I was in and out of our doctor’s office many times and saw two of the GPs there, but received the same rubbish treatment each time. I was fortunate to obtain a referral to an exceptional Osteopath for ongoing treatment of a back issue, but that was my BEST experience in the UK. That doesn’t negate the many other times in which the NHS was spectacularly disappointing.
The fact that they didn’t perform a check-up on me before prescribing Birth Control, for which I was offered no education or options, still shocks me. That they could not recognize the classic symptoms of migraines like one-sided debilitating head pain, sensitivity to light, nausea, and aura, confounds me. Instead, they told me to “take some paracetamol (tylenol) and a nap,” a COMPLETELY ineffective treatment of migraines.
Then there was my 4 severely impacted wisdom teeth which were threatening the health of my other teeth and were in need of surgical extraction – three years I searched for a dentist with availability and found NOTHING. We could not afford to go private and so I sought the help of the hospital and they TURNED ME AWAY. It was not until I arrived back in the US that I was told removal was absolutely necessary for the health of my other teeth, and had them surgically extracted under general anesthesia. THE BEST $900 I HAVE EVER PAID. I was lucky to have dental insurance, but even if I hadn’t, I would have gladly paid thousands more for the necessary and impeccable service I received.
If I had been in a car accident in the UK, I’m sure the care I would have received from the NHS would have been SUFFICIENT. And I certainly would have been glad that it was “free.” But what I don’t appreciate is having to fork over 40% of my husband’s income in taxes for a service that we rarely relied on and never got decent non-urgent care from.
I read almost all of these comments: again and again I see people proclaiming how the NHS came to their rescue when they were in dire straights. GREAT!! That’s awesome. The NHS is fantastic where that’s concerned and I’m completely glad that poor people get care and don’t have to pay. But in terms of those daily health issues that make life just plain miserable, the NHS falls sharply flat! Blood tests? What are those? Check-Ups? Health Education? Nutrition Advice? Better check the Oxford English Dictionary!
Yes, the US Healthcare system is wasteful. Yes, the US Healthcare system is profit oriented and expensive. Yes, the US Healthcare Insurance System is often unfair and underhanded. But Frankly, *I* would choose the US Health Care system every time!
I want you to know that I am saying this as a CURRENTLY UNINSURED DUAL NATIONAL LIVING IN AMERICA. I have witnessed the true cost of American Health Care costs. Just a few months after I moved back, I was in the Emergency Room with what might have been an Ectopic Pregnancy. It turned out it was an Ovarian Cyst. I incurred $10,000 in bills, $5,000 of which I had to pay for out of pocket. I had a cheap, emergency only short-term health care plan which cost me nothing and did not cover pre-x conditions. It was bare minum coverage every working person should be able to afford. In fact, we did not even have income at that time and yet we still managed to make those premiums. The insurance covered $4k of my bills without question. My care in hospital was superb, I was seen quickly for a busy ER, and although the bills certainly hurt, all of the providers were more than willing to accept $20 per month payments until it was paid off.
A few months after that, I had a bad experience with a US Chiropractor (see, its not all one sided!) who signed me up for 6 MRIs of my cervical spine and brain. The bill came to $12,000 and the provider SWALLOWED $5,000. My insurance company (an average, affordable, individual-paid plan) paid for the rest and I never had to fork over for my $2,000 deductible or the 20% co-pay because the MRI company was out of network. I didn’t pay a single penny, and my insurance was nothing special. The MRIs were largely unnecessary (done because of my migraines) but they did find a minor cervical disc bulge in my spine. Despite the fact that I didn’t really need these MRIs, I’m still glad I had them. There’s nothing quite like knowing you definitely DON’T have brain cancer!
I’m appreciative that the provider and insurance company settled the fees between themselves and never sent me a bill.
Now the bad news. Years passed, I eventually switched to my husband’s employer subsidized gold-plate policy. But when he changed jobs, the new company’s insurance was too expensive for me to be on. That’s when the disc bulge (which my MD says is not of significant concern at this time) came back to haunt me – its considered a high-risk pre-existing condition and, as a result, I have not been able to qualify for individual health care insurance policies. I’ve been on short term policies for over a year which do not cover pre-x conditions, but they are a cheap alternative for emergency coverage.
Am I mad? Yes. Mad as hell. Mad that my husband would not be insured if not for his employer. Mad that I’m considered high-risk when I’m perfectly healthy. But you know what? I WOULD STILL CHOOSE THE US HEALTH CARE SYSTEM OVER THE NHS ANY DAY. And not just because of my own isolated experiences – I’m not that insular!
I like knowing that I am a participant in my health care in the US. I am encouraged to educate myself, listen to my body, and talk to my doctor about my options. I am held accountable and so is my doctor. I like knowing that I have top rated care available to me anywhere in this country and that cheaper options exist if I need it. I like knowing that if the shit really hits the fan, I will still be treated and providers will negotiate their prices with me and accept payment plans that are affordable for me. I like knowing that I only pay for WHAT I USE.
Insurance is really important while the costs of Health Care in the US are so damn expensive. Its true, they’re extortionate. $12k for MRIs! $200 for my Migraine Rx (9 pills)! This, and insurance fairness, is where reform is required. Like Banks and Mortgage companies are punished for predatory lending, so too should insurance companies and health care providers be punished for unfair practices and prices. This is coming.
Until then, I’ll reiterate what I said. I like knowing that I’m paying only for what I use. That 40% of my hard earned wages are not being docked from my paycheck for a sub-standard service I might not even use.
Finally, I’ll add that I had no preconceptions about the NHS and knew nothing of it when I moved to the UK at the age of 19. I also had very little experience of US Healthcare. My grandparents and I were not insured so I didn’t have some unattainable level of service in the US with which to compare the NHS to. Before I moved to the UK my adult medical care consisted of one visit to a chiropractor who was great, and one visit to a GP for a Birth Control Rx who proceeded to lecture me (at the age of 19) about how wrong it was to have sex out of wedlock! I didn’t get the prescription.
My experiences were simple and I didn’t make anything of them other than that I had a good chiropractor and had encountered a religious nut of a doctor. So when I speak of my experiences of the NHS and of the US Health Care system, they are unencumbered by preconceptions, misconceptions, familiarity, or bias. My experiences are what they are. And if anyone should tell me that my experiences are due to “location” flukes, “culture shock”, or any other such nonsense, I would kindly ask that person to consider weather they are truly interested in listening to and accepting someone else’s opinions and experiences, or if they are merely interested in dictating who’s right and who’s wrong.
The truth is, both systems have problems and both systems shine in certain areas. To peg the NHS and “socialist health care” as Evil is simply wrong. Does the NHS suffer from complications of the way in which it is paid for and managed? Most certainly! But it does certian things well, and it should not be belittled or trodden upon for that. America could certainly take a lesson! But so can the NHS! Preventative health care and doctors who are supported enough to care can go a long way!! If only my doctors had opened their eyes, I wouldn’t have suffered every day of every year I lived there, and my husband wouldn’t be facing a retirement ridden with diabetes complications and maybe even insulin! Dare I say, my mother-in-law, whom I never had the chance to meet, might even have lived long enough to see her son get married.
I don’t think its unfair to say that both systems have a lot to learn, but NO SYSTEM should be labeled as inherently bad either. They are simply DIFFERENT.
@ Sarah
“I’m completely glad that poor people get care and don’t have to pay”
How patronising. Horray for “poor people”.
I’m sure you didn’t intend it to sound like that (even if your husband being taxed at 40% clearly proves your are NOT poor).
Incidently, only a small slice of that 40% goes on the NHS, and most of that small slice will go on helping OTHER people – something I suspect you are opposed to based on some of your post.
It’s a shame that your experiences are negative. As with all things, there are (as you can see from other comments) many opposing experiences.
The NHS saved my fathers life, and saved me and his other two kids loosing their father at 45.
It’s not perfect, and I doubt you’ll hear ANYONE on here claim it is. The response here is mostly based around claims it is “evil” (for the rifle bearing she-bear).
The NHS and the BBC are two British institutions that no British sane person will ever let any government take away from us.
Fox News and $100k to have a baby? *shudder*.
I’m guessing that all American’s apposed to a public healthcare option would be equally as apposed to privatising the police force, the army, education and the fireservice. Yet I fail to see the difference.
In america you call 911 – if you choose Police, it’s free. If you choose Fire, it’s free, if you choose Ambulance – NOT FREE!!
Incompreshensible to me…
I absolutely believe your experiences are true, but I am absolutely boggled and flabbergasted. I’m used to minor incidences of failed care (as in any country, we have some useless GPs who should not be in work – speaking of which, is there any chance you could name and shame this GP to the relevant Patient Care Trust?). Your treatment was appalling. The thing is, *by the standards I am used to in the NHS* your treatment was appalling. No, seriously, I’m shocked. I’m sorry you’ve had such crappy treatment under the NHS.
BTW, I’ve been poor. I am now relatively well to do. My income has never yet affected my treatment under the NHS – although I could go private, I don’t feel any urge to do so. It’s not just for ‘poor people’, it’s for everyone and everyone uses it.
I am aghast at your experiences in the NHS. I have never heard anything like that – and I have lived here all of my 52 and have had many friends and relatives treated by the NHS. To find such incompetence at work is alarming. Did you complain and have these people struck off? You should have done.
What worries me is your claim that your husband paid 40% of his wages for the NHS. No he didn’t. He paid 40% on some of his wages – over £40k. He paid 20% on some, and nothing on his first £5k or so. This was general taxation. It paid for schools, the police, the Navy. It paid for the NHS, along with National Insurance contributions, and it paid for tanks for Desert Storm/Iraqi Freedom. It was taxes, just like the IRS collect in the US. It was not an NHS levy.
We spend 8.5% of our GDP on healthcare, compared to 16% in the US. This seems like incredible value to me. The end result is that we have a longer life expectancy than US citizens, and fewer of our babies die in infancy (actually fewer babies die in infancy in Cuba than in the US, which is a fair indictment of your system). The WHO rated us 18th and the US 37th in terms of the healthcare we provide to ALL our citizens. The NHS must be getting something right.
Of course, it would be nice to live inside the BEST system in the world, the French one, but while Britain blindly follows right wing Presidents into badly thought out foreign adventures costing us a large chunk of the 40% I pay on PART of my income, the British will have to lump it.
At length, individual anecdotes, subjective as they must be, can never tell the whole story, but it is interesting to note that most of these anecdotes stress pride in and gratitude for NHS staff and the work they do. However, if you want to arrively in this world safely, hope to survive in it despite your level of income, and dream of being able to afford care in your declining years, then the official evidence suggests that is better to be born in the UK. or France, or Germany, or Sweden, or Finland, or Norway, or Canada, or Australia..New Zealand, ..Holland..Belgium..Switzerland…Denmark….another 23 countries… than in the US.
I’m deeply sorry about your experiences and obviously nothing I can say or do can make it better but I’d just like to point out that National Insurance Contributions for the employed are 11% not 40%. The employer also pays a certain percentage of your salary on your behalf (not sure how much). The money is then split between provisions for healthcare, state pension and unemployment benefit.
Sarah, I can only echo what others have written in response to your comments – I am truly sorry to read about your experience. In the UK you have a legal right to a choice of GPs and healthcare practitioners, and a legal right to ask for a second opinion. It is unfortunate that you presumably didn’t know about that option.
But I would also like to point out a glaring inconsistency in your portrayal of your dental care. You said in the UK “we could not afford to go private”, yet back in the US “the best $900 I have ever paid” and “I would gladly have paid thousands more”. At the risk of sounding insolent, which is it?
Also, we don’t pay 40% tax. The first ~£5k of earnings is tax free, the next ~£35k is taxed at 20%. Only earnings over ~£40k are taxed at 40%. Lets say you earned £60k in a year (I wish I did, then I could easily afford private dental care!). You would pay 0% tax on £5k (£0), 20% tax on £35k (£7k), and 40% tax on the remaining £20k (£8k). You would pay £15k in tax on a £60k income, which is 25%.
Finally, you seem not to understand the concept of insurance. You say: “I like knowing that I’m paying only for what I use. That 40% [sic] of my hard earned wages are not being docked from my paycheck for a sub-standard service I might not even use.” Insurance is a form of pooling risk. Lots of people pay a small amount to cover a potential much greater loss that may be incurred by a few of those people, but you may be one of those few therefore it is worthwhile. Even in the US system, if you buy health insurance, while you hope never to have to need it, if you do need it the potential costs covered may be far greater than the amount you have contributed. You would in effect be paying for other people’s healthcare if you yourself don’t get sick.
Again, I’m sorry to read about your experience, but get your facts straight before you comment next time.
Clearly, you’re lucky enough to be rich enough to afford to be insured in the US at all.
The whole point of the idea of socialising US healthcare is to provide something for the people who are not as lucky as you – however patronising you may be about “poor people”, there are plenty of people in the situation where they cannot afford insurance in the USA.
Sounds to me like you had the bad luck to wind up with one of the worse primary care trusts over here, one of the handful of target-failing ones. They really aren’t all like that – not even mostly.
chammond
In the UK diabetics do not pay for insulin, insulin pumps, needles, blood testing kits, anything.
Unless they want to – you have the option of seeing doctor’s privately.
I lived in the UK for 7 years. What the NHS is especially good for is every day medical care and care for the chronically ill. You could see a doctor the same day you needed to if necessary and they will come to your home if you are too ill to get to them.
When it was time for a pap test or mamogram they contact you to get you in.
The doctors are in your neighborhood not miles away.
If you needed to see a consultant a letter had to be sent, which was annoying but when you see the qualiy of base line care who could complain?
On the BBC this morning the Brittish people are up in arms at the way their system is being shown on American TV.
I am now in The Netherlands and the locals as well as myself seem very satisfied with it.
Just having some health coverage, no matter what is going on within your life, gives such peace of mind.
Re: preventative care. My experience between US and UK was different. I never got called in to America for much preventative care EXCEPT when it came to pap smears. I also wouldn’t complain if I was called in for preventative care if my age warranted it. Better safe than sorry. Thankfully it was ingrained to be checked, too, as I had a brush with cervical cancer at age 20. When I lived in the UK, paps were given once every 3 yrs. In USA, once every year. I think having it checked yearly was a positive thing.
Due to the cervical cancer…when I moved to UK I did tell my GP (General Practicioner) about my history and expressed my concerns about waiting too long between smears. He arranged it so that I may be checked yearly. That was on the NHS. The NHS does have flexibility but you have to explain and demand. Otherwise, change your GP and find one that meets your needs.
Before moving to UK, I had an ectopic pregnancy. At the time I was working full-time but could not afford medical insurance. (Yes, this is true and many people in America are in the same boat. Some people look at it as ‘everyone can afford insurance in some form. NOPE.) The company I worked for was a start up and offered no in-house plan. I incurred a $14K+ bill for emergency surgery to save my life. I was hounded by collection agencies and told to ‘pay what I could’. Nightmare. I ate pb&j sandwiches for months so that the sob hospital could be paid for stuff which was incredibly expensive. $25 for a sanitary napkin? Yeah. I did NOT quality for state aid to pay the bill as I earned just enough to not qualify (within $100). Nice, huh?
While living in UK, I was involved in a serious auto accident. Ambulance ride required to hospital. Xrays. Tests, Etc. I was surprised that all I had to do was tell them my name and address. My NHs coverage handled everything. No papers. No phone calls. Nothing. My tax money helped me when I needed it most.
America could learn from the NHS. The NHS isn’t perfect, but at least you need not fear going into lifelong debt if you are caught in unfortunate circumstances as I was.
Lets add some other countries with “Socialized” medical systems to the debate. I am an American living in Germany, which has a far less “socialized” system than the UK, but the system has most of the same safety nets to cover those who need care.
I wacked the end of my finger off while whiping up a pizza a few years ago. Went to the ER, was seen in less than 5 minutes, had a hand surgeon on site within 30 minutes, and was being sewn up inside of 45 minutes. Best part is that nobody ever asked me how I was going to pay for the care. 30 minute surgery by a specialist, pain meds to last for 10 days, 6 follow-up visits, and stitches removed. In the US that would have cost me at lest $5-8 thousand. Final bill… 98 EURO. I didn;t even submit it to insurance, just sent a check. Why so cheap? Because the govt controls costs.
Employed must have health insurance in Germany, and unemployed receive it free. It is not cheap, but it is a lot cheaper than in the USA, and the quality is excellent.
Got to love the Republican adds about quality of care so high that foreigners come to the US for care. Sure…if you can afford the Mayo Clinic or some other world class hospital (which most US insurance companies will not cover) you get great care, but the average urban hospital is as dirty and has all of the problems as those in third world countries. Community health clinics have lines out the door, and we have all seen the horror articles about people dying in the ER waiting room and being stepped over by nurses for several hours beofore anyone notices.
On a recent visit to Philadelphia, I was walking into a shopping center and helped a lady get out of her car as she was using two crutches. Asked her why the crutches, and she said that her GP had diagnosed complete erosion of the cartilage in both knees. She needed joint replacements desperately. At 61, laid off from her job…which did not offer medical insurance anyway, she does not qualify for MEDICARE yet, so her plan was to live with the pain and two crutches for four more years until she would be covered under that system. 43 million Americans are in the same situation living without medical coverage of any kind, and the Republican scare mongers stack the Town Hall meetings with people who scream about loss of benefits. What benefits? Lose your job, lose your benefits.
Too many US politicians are in the pocket of big finance…i.e. big insurance companies who make the true killing on health care costs. Case in point..who got the bail out TARP money? Not the struggling manufacturers and small businesses. Not the consumers who were conived into taking out loans on absurd conditions. AIG and associates got the bail-out.
Living in Germany for 12 years now, I have heard my share of complaints about the medical system, but I have yet to meet a German who would trade it for the American one.
I’m not so sure it’s a good thing that LondonMitch was being regularly checked for “cholesterol, etc.” in america whilst people with real problems could not recieve care. In my opinion I’m glad the NHS does not overly cater this to the hypochondriac, preventative care can only go so far besides educating. I’m sure most gents in the uk would be embarresed for wasting the doctors time. Man up haha
Bravo – a terrifically balanced addition to the debate. This is already firing itself around Twitter.
To add my 2p-worth, the NHS saved my Father’s Life when he had a heart attack, and treated my Mother’s breast cancer. It delivered my two daughters safely – one of them at home when labour came suddenly and very quickly. Within an hour of my wife calling her midwife, she had two midwives and an ambulance team tending to her. When my daughter had her first (and so far only) anaphylactic reaction to nuts, we raced her to the GP surgery and she was seen in minutes, bypassing the waiting room of people with appointments for less immediately urgent concerns.
It has given my Father-in-Law the chance to see his children marry and have their own children. He was made redundant in his 50’s, and would not have been able to afford the insurance, let alone pay for the heart bypass operations and years of subusequent treatment.
Treatment is free at the point of use, and determined on clinical need. Not income, whether your company policy is a good one, if you made a mistake on your form. It’s simple: are you ill? Can we make you better?
Chammond:: Your post pretty much sums up the problem. You can see the faults in the current US system but the massive campaign of propaganda and scare-mongering from groups with vested interests means that you fear alternate systems but for no tangible reason. Under the healthcare system in virtually any other industrialised country (including the UK) your son would receive free (or affordable) healthcare based on his need, leaving you to spend you time, energy and money on looking after him and the rest of your family.
chammond as someone from UK that is quite sad to read.
I do hope that your Son is OK and can lead a good life.
If you was in UK though the only one thing you would have to worry about is your sons health, not how you are going to pay for it.
http://www.nhs.uk/Conditions/Diabetes/Pages/Introduction.aspx
The NHS does have a few problems but honestly they are few.
It has improved 10 fold over last few years and am proud our system of care.
It is nice to see someone from abroad giving their opinion. The NHS is not the best and as your post points out, it probably never will be. However, since WWII, we have take it as a give right to walk in and get medical care. People must also note, the NHS allows us to go anywhere in Europe and get free treatment when on holiday. I have done it and it is something we can be proud of as no other government would allow this. Nice post!
I’m amazed at the number of comments and the traffic this post is getting. How empowering for you Strawberry to be able to help people throughout US and UK to stop and think about this.
I think you were absolutely right when you said: “…when you take the American situation as a whole — the people with gold-plated insurance policies, the ones with merely adequate policies, the underinsured, the uninsured, the people who will lose their insurance because of illness or job-loss or impossible cost — the comparison looks very, very different indeed.”
I do believe the American people need to see this as a whole. Individual stories do come into it. Some have really great experiences and people like me have horrible experiences under the American health care system. But, if America wants to be considered a civilised society and continue with it’s image as one of the greatest countries in the world….then it needs to act like a civilised society and everyone needs to put there bit into the pot to make sure that the whole of USA is taken care of.
There is too much the philosophy of: I work hard to take care of me and my family and if you don’t work or can’t work…then that is your problem. This way of thinking must change if it wishes to continue being a “great nation”. America has one of the craziest health care systems on the planet…it has a bit of this and that all mixed together to make one big complicated mess. My elderly father finds it exhausting and incredibly confusing to always be filling new forms.
On one of my most recent visits to US I was visiting a close friend who had been made redundant at her work therefore she had lost out on her health insurance. She was sharing with me the fact that she only had a few more heart pills left before she would run completely out and she didn’t know how she was going to come up with the money to get her next prescription. In my mind as she was talking I was considering giving her at least $20 to help her out with her next prescription until she could get something sorted out. But, in her next breath she began discussing the new health care reform and how ridiculous it was and that there was no way she was going to support socialised medicine. At that moment in my mind I said to myself….fine…if you want this horrible American health care system that allows you to miss out on health coverage when you loose your job or find out you can’t work any more….then you can have it. And I decided not to be generous because it appeared to me that if I had been generous I would be doing the very thing that she would be against overall.
I am completely puzzled by the fact that my father and most of our friends who would benifit the most from the new health care reform…are the ones protesting it the most. They claim it is not the Christian way. And then my mind goes back to the scriptures. Jesus was clearly not into the capitalist mindset. He never owned a thing. He lived in someone else’s home, he rode someone else donkey and he even borrowed the tomb he was buried in (and may I add…rose from). I think of the story of the boy with the fish and loaves. The multitude was hungry and the little boy was the only one who had thought ahead and packed a lunch. The republican version of that story would be quite different. I can imagine their version would have Jesus saying to the multitude….”You see this boy with his packed lunch. He thought ahead, he prepared his lunch. But, you lot have not prepared anything, you have not thought ahead…too bad for you. You must sit there hungry, watching this boy eat his lunch.” But, in reality he did the complete opposite….he performed the miracle of dividing the fish and loaves amongst the multitude. He spread the wealth.
My particular reply to this thread is for my fellow Christians out there who think that the new health care reform is not Christian. Perhaps you should rethink this and look at the scriptures again. The Bible contains more than 300 verses on the poor and social justice.
Jeremiah 22:16 – “He judged the cause of the poor and needy; then it was well with him: was not this to know me? saith the LORD.”
My own opinion of nationalized health care was somewhat soured after my mother’s stories about cancer care in Canada (not her own as much as some of the other people’s stories), but I’ve always supported at least a single payer system.
However, there’s one thing you hit on that really hit home for me: people keeping jobs they hate for the health coverage. People not being able to move on in their lives (for example, staying married to someone they should divorce) because they can’t afford the health coverage consequences. Those have long-term life implications.
I’d never considered these subtler side effects (and, honestly, I’ve been so wrapped up in the household medical issues to listen too deeply to what various parties are saying about proposed plans here in the US — fortunately, we have great coverage).
I am reminded of the story about a man who had a beam in his eye, trying to help a man with a splinter in his. No doubt the NHS would have helped both of them, without any charges!
Only if they were already blind in the other eye, Francis: this is the NHS which refused to pay for treatment of macular degeneration in the first eye, since preventing the loss of sight in one eye was considered too expensive. It’s only once the second eye is threatened that you met the NHS’s criteria: they’ll pay to prevent you going entirely blind. (Yes, I think political pressure has since changed that particular policy, but it’s hardly unique – and the underlying system is still very much in place.)
Great article, thanks.
As a Brit that has lived in several other countries, I know how incredibly lucky we are to have the system that we have, imperfect as it may be.
I notice that my reactions to the ongoing debate are getting increasingly visceral. It’s not just the half truths and outright lies that are being thrown around (“death panels” – sheesh!) Rather, it feels as though some fundamental part of my values is under attack and finally your post nailed it for me:
“Brits believe that healthcare is a human right”
You’re right – this Brit does at least. But I never realised until now how arrogant I was, believing that this is a universal worldview. I’ll be making my arguments from a different, and hopefully more productive, place from now on.
Thank you for a calm, balanced and extremely well written post.
Well written, Strawbs! You are making quite the rounds on facebook! I never had to use the NHS when I was in the UK, so can’t comment. But here’s my experience in the US…
I worked for a large company whom you’ve all heard of, with one of the best benefits packages according to lots of different rankings. Most of my friends were envious.
I was experiencing some health issues, so I opted for our highest cost / most benefit health plan, which had a$150USD/mo bill, as well as copay ($25 visit $75 per specialist, etc, etc).
This best around health care also covered 80% of hospital bills, and stays up to the limit. Sounds great?
Well 20% of the hospital bill I would have had would have put me into bankruptcy forever. I would have been looking at probably somewhere in the $50,000 to $100,000 range for a fairly mid range surgery.
Toss that on top of my student loans, and I’da been done.
With the over inflated cost of US health care, I was looking at the surgery and probably 5-6 days in hospital recovery, plus the follow up – all of this done while at 2/3rds pay through my employers insurance plan (which worked out to $6ish an hour, thanks to a loop hole they found.).
I chose not to have the surgery.
As it was, things got bad enough financially, that I had to move back in with my folks – and I still need the surgery.
Would I take an NHS type system? H*** YES!
As it is, I try to do my best, and hope every day that my innards don’t try to kill me.
Thank you for the wonderful blog!
Your original post and the vast majority of comments are an island of sanity and reason in a sea of prejudice and lies. I’ve just ‘wasted’ an hour when I should be working reading through them all but I feel a great deal more positive about my fellow citizens than I did when I woke up this morning.
Us British – or certainly us English – are a passive, uncomplaining lot most of the time. It takes a lot to get us worked up and even more to get most of us agreeing with each other. In many ways we should thank the American right (and assorted British nitwits like that Tory Euro MP who went on Fox News) – they have made us look at what we have in the NHS and realise that it’s a bloody good thing that we should be immensely proud of.
Other than that I can’t improve on Eric Ross’s summary – ‘it is truly a model for the rest of the world….just testimony to what a fair-minded society really must do.’
Sarah, I’m sure you’ll get plenty of responses to that post so I’ll restrict myself to a couple of points.
There are some crap doctors on the NHS; and there are some crap doctors in the private sector as well. I daresay there are some crap doctors in the US. You clearly had a bad – I would suggest unusually bad – experience. I’m not sure it has anything to do with pay. That comment might tell you a lot about the different approaches to healthcare. I firmly believe that most doctors in the UK practice first out of a sense of vocation and second as a means of making a good living.
I’m no cancer specialist but I’m sceptical that your mother-in-law had diagnosable and treatable cancer for 15 years before it was finally caught.
And finally, your husband did not pay 40% of his income towards the NHS. He paid 40% of his income towards all public services provided by the government – the NHS takes a big chunk of this but by no means all.
None of which will make you feel any better about the care (or lack of) you received. But as the original post said, a few bad apples do not make for a bad system.
@Sarah I’m sorry to hear of your bad experiences. I wonder about the timing of it, because things were pretty bad under the Tories, and took a while to improve.
Of course there are some lazy, incompetent GPS. I’m sure some private doctors are bad too. You were unlucky enough to get two in a row. Remember though, you do have a choice, and can keep trying with different doctors.
Some of your comments don’t gel with my own limited experience. When I got hypochondriac about my heart (for no good reason, I should add) – I had a cholesterol test on the NHS, very quick and easy.
The NHS web site is brimming with healthy living advice, clinics are full of leaflets, they advertise, etc. — which makes good sense because a population that lives healthily is a good way to keep NHS costs down.
As a UK citizen I’d like to briefly comment on the medical system in the UK.
I spent my first year of life in various NHS institutions – with mixed results (back in the early 1960s). My NHS experiences as a child and younger adult were fine – and back then dental care (& dental hospital operations) were also free to me at the point of issue.
By contrast my experience of UK private medicine has been less satisfactory. I got a variety of jobs with (top) tier ‘A’ private medical insurance – but after paying private medical insurance premiums to the same series of medical insurers for 23 years payment for a treatment was declined (with no refund) when I developed a condition as it was classified as ‘long term and ongoing’.
I’ve been totally reliant on the NHS again for a couple of years – it’s not perfect, my GP’s surgery appeared to be shambolic (It’s since much improved) and I have had issues with two different Local Health Authorities each saying that I should be dealt with the other one. However I get each of three expensive monthly prescriptions for £7 or less per instalment, a GP’s appointment within two days on average and practically instantly when an emergency arose, and referrals to two local NHS hospitals as required.
I believe that the NHS does need reform, as my own experiences have revealed a layer of bureaucratic infighting that has restricted my treatments.
However my experience of private healthcare in the UK not being there for me when I needed it has only reinforced my conviction that state financed healthcare is essential for a ‘first world’ country.
The NHS exists because health is an important human right. Healthcare in the UK is not a money-making scheme.
It has its flaws but in my opinion the monetary benefit and absolutely unlimited access to medical advice clearly makes it the better choice – if you’re in a road accident and the doctors have to spend 5 hours putting you back together – there isn’t some bureaucrat with a form waiting for you when you wake up.
besides – even if you don’t like nationalised healthcare – you can STILL have private healthcare if you WANT it.
I think Matt (above) sums the entire argument up in his final sentence. In the UK everyone has access to healthcare regardless of social or financial status. If some don’t like it, or are unhappy with the level of “service” then the option exists to pay for more personalised PRIVATE care. How can having an underlying system like the NHS be a bad thing? Surely in todays world people who pay for private can’t begrudge paying taxes to take care of those not as fortunate as themselves.
Individual examples of why the NHS is good or bad are fairly pointless as good and bad cases will exist for any service. For me personally my gran died in hospital following a period of half-ars#d care, whereas my dad has recently been sucessfully treated for quite an advanced cancer of the colon. I don’t think either example is useful in determining whether a system like the NHS is good or bad.
I would argue that actually the NHS provides the highest level of service\competance available. Its my impression that the benefits of private care are only a quicker route to service and perhaps treatment occurs in a more personable\private environment.
I’m all for the NHS.
[...] This American’s Experience of Britain’s Healthcare System: here. [...]
Very well written, thank you. I agree 100%. I’m an American living in the UK, and my experiences with the NHS have all been really really good, and I find the NHS much better organised than anything I ever had in the US. It has its faults, yes, the hospitals tend to be dingier and staffing a problem and there are longish wait times for things that aren’t life-threatening. But as you say, I’ve seen all of those in the US as well, the difference being that I wasn’t charged an arm and a leg for the privilege in the UK. I was once told when I went to see a doctor in the US whilst uninsured to ‘Google it’ when I asked a question, spent 10 useless minutes with him, and then was charged a whopping $200 for it. Anecdotal, yes, but it shows that service in the US is by no means perfect, only much more expensive.
I am also an American expat in the UK but I’ve only been here for a year. After I turned 18 in the US, I had no insurance because (1) I was a student, (2) I worked part-time, and (3) the money from #2 mainly went to living and #1. I finally switched to a job that offered insurance to part-time employees. It’s a very large multi-national company that has ranked in Fortune’s ‘100 Best Companies to Work For’ consistently over the past decade or so. What is the first thing anyone does (or should do) when they are insured? Go for a checkup (as I hadn’t stepped foot in any medical setting for over 10 years, it was long overdue). It was discovered that my consistently stuffed nose was something that needed surgery to correct. I got referred to an ENT without any problem. Sure, I had a wait of 3 weeks for the initial appointment because he was the only ENT in the greater Denver area that had availability and was within the network. By a stroke of pure luck, I was able to squeeze into a surgery slot just 2 months later (another patient canceled). Everything was pre-approved; I even have the letter to prove it. My coinsurance was a 90/10 policy, so I had to pay a meager $200 on the day of the surgery. Everything went well, as expected, and I was home.
If the story ended there, I don’t think I would have anything really negative to say about the healthcare experience in the US; sure, I’d have thought it’d be nice if there was a way to help the un-/under-insured, but I wouldn’t have had any negative experience. But the story didn’t end there. 4 weeks later, I received letters from the insurance company and from my ENT regarding payment and that I shouldn’t worry about anything then. In the end, the insurance would not pay the claim because they claimed it was an acute illness and they’d only pay for chronic illness-related surgeries. After a year of conversations with numerous hands, the insurance company paid a large portion of the surgery. However, I still owed the ENT an additional $1700 and the outpatient clinic over $20k. Why? The ‘pre-approved’ letter meant nothing and the insurance company decided he outpatient clinic wasn’t necessary for the operation, as well as the ‘insurance’ was really just a discount for the ENT’s bill. All of that is on top of my $100/mo premium (well, the actual amount is $400/mo but I only pay $100 because of the contract between the PPO and my employer).
This was just a few years ago and I’m still in school as I had decided long ago to run the extent of my education. I’m now in the UK (as a student still). Of the debt that I will have accrued by the time I finish my last degree, 20% of it is medical and without deferment. I’ve been lucky enough to work out a payment plan for the medical bills, but I’m barely keeping up with the interest–and that’s mainly thanks to a good exchange rate from the UK to the US. I haven’t had many problems in the year I’ve been in the UK, so I can’t really say how great or horrible it is. However, I haven’t had any difficulties with the NHS or my GP. I’ve had to adjust to my GP’s scheduling system (e.g. they have appointment periods reserved for the day of visits and these are first-come, first-served from 8:30; walk-in clinic times are 2:00-3:00; a ‘regular’ appointment tends to be 3-5 days out), but that doesn’t mean the NHS itself is bad or silly in its management practises. I’ve had friends rushed to A&E (ER for the Americans reading this) with holes in their hands from knives and seen them back within a few hours (including the time it took them to travel there and back on public transportation). No system is perfect, but I think the NHS is overall a good system that meets the needs of everybody in a more efficient, less costly manner. Yeah, people do pay a tax, but I know from looking at my paychecks that it costs me less here to cover my wife and I than what my premiums alone cost back in the US, let alone the prescriptions we are both on (which before I left the US was running $90 a month).
It seems to me is that a lot of people are missing the point. The NHS is not perfect. Nothing is perfect. But it is a service for all. How there can be any defense of a system whereby only the rich can afford healthcare is beyond me. Forget the crap experiences you’ve had with the NHS. Do you really think no one ever has a crap experience with a doctor in the US? Of course they do. That’s life. Poeple that are shitty at their jobs exist. However, overwhelmingly, this debate has shown that a good majority of those living in the UK are happy with the NHS and are supportive of its existence.
Now the real point: poor people are denied healthcare in the USA. People who cannot afford medical insurance and do not have jobs with good healthplans and that do not have pots of money to put aside in case they get sick, do not get the medical treatment they deserve. The question is really about whether we care enough about our fellow citizens who cannot afford healthcar.
If I grew up in the USA my family would be bankrupt and would probably not be taking the medication they need. The idea of that scares me and horrifies me. For all the individual cases of the failings of the NHS, I would never want to live in a country where such a system does not exist. It has never failed for me, but I see that it fails for some. Quite frankly, it’s true, you have to be pro-active about your care in the UK sometimes. If a doctor or surgery is not working for you, change, try harder. Nothing is more important than your health and if you’re so sure it’s a failing of the NHS system, rather than just a bit of shitty luck, you have every option to take up private healthcare. That’s the great thing about it.
Claire, to add to this point:
“Now the real point: poor people are denied healthcare in the USA. People who cannot afford medical insurance and do not have jobs with good healthplans and that do not have pots of money to put aside in case they get sick, do not get the medical treatment they deserve. The question is really about whether we care enough about our fellow citizens who cannot afford healthcare.”
Americans kid themselves if they honestly believe that they are paying only for what THEY consume when it comes to the current healthcare system. Hospitals treat uninsured or underinsured people quite often, and quite often uninsured or underinsured people cannot afford to pay their bills. These debts obviously then are absorbed by the system, which drives up costs across the board, and in the end, Americans DO pay for the uninsured by rising treatment costs, rising insurance costs, rising tax bills, etc. Just because the costs are hidden doesn’t mean the average American isn’t paying for more than their own medical bills – which is a big argument of the pro-capitalist system that is totally off the mark IMHO.
Actually, Claire, it isn’t the “poor people” that are denied healthcare but many of the “middle class” that are finding themselves not affording medical care in the US. Also, having employer-paid insurance (actually, a premium is taken out of each paycheck), doesn’t guarantee you a good health plan…and I work in a hospital!
A friend recently dx’d with breast cancer, went through surgery, chemo and radiation…the cost $200,000K! I’m not denying the medical costs may need to be high to cover costs, but..ouch! That happens to me…I’m sunk!
As far as the prescription cost in the UK, currently for each medicine, you pay £7.20, that may be for a one off antibiotic, or it may be a regular repeat. If you do need a whole cocktail of drugs, you will oftem be exempt from paying, or there are option for a prepay card. The £7.20 is extremely good value when you look at what it covers, the pharmacy costs, and the medicine itself, whether it is a cheap painkiller, or a £65 inhaler, you can even get Viagra on the NHS (normally £5 per tablet!)
Currently in the UK, the number of unemployed current stands just below 3 million, 7.6% unemployment, but even the unemployed, homeless and generally those living on the breadline, can still get NHS care! In the US, the unemployment rate is even higher, at 9.5%, think of the consequences this creates at the lower end of the spectrum in the US.
The NHS may have problems, but for the general population, it is a godsend, and for those lucky enough to afford better healthcare, there is a brilliant private sector running alongside.
What I really like about the pre-pay system is that if you lay out for a yearly prepayment certificate, it works out at only £2 per week, which is really great. Especially considering that the majority of people who might not be able to afford to buy one with a single payment usually get free prescriptions anyway.
-I am a doctor practising in the NHS. I have private healthcare as no healthcare system is perfect. But, if there were no NHS I might as well practice elsewhere.
This is because I have worked in healthcare systems that are based on capitalism. And I have seen what levels fellow colleagues can stoop to earn those ‘mega millions’. Did they have my respect?
The reason I left my country and love working in the NHS is because:-
*my decision making would never be compromised by how much I can make for myself or my employer. I would never have to order unnecessary investigations just so that I can profit.
*I would never have to turn away a patient because he or she cannot afford my services.
*In my decision making I factor in not just what is good for my patient but also what is good for the society and the country as a whole. e.g. antibiotics.
* I treat all my patients as equal and provide the same service irrespective of their bank balance.
* I don’t worry about competition from other healthcare providers as my income is not affected by that. So I don’t have to resort to unscrupulous means to ‘keep people happy’.
*And I still earn reasonably well. I may never be a millionaire but there is hardly anything I desire but cannot afford.
* My practice is audited and appraised at regular intervals so I don’t lag behind in professional competence.
*My conscience is clear and I get a good night’s sleep – everynight. It makes me feel I have done my best for humanity.
Is there any other such healthcare system? I doubt.
Scotland, NHS experience: Had an appointment with a doctor this morning. Surgery waiting room nice and peaceful, only two other people there. I was taken straight away by a very friendly doctor. I’d gone about something minor that had been dragging on for months, and therefore needed to be checked again. The doctor was very helpful, also asking whether I’d had my blood checked – I’d had very bad anaemia last year and am on long term iron supplements. I get blood tests once a year, a whole battery of tests last year when I was most ill. Any time in the past I’ve suspected I needed a test, the doctor did it without argument. Recently she sent me my new iron prescription in the post before I’d even ordered it. When I originally saw her last year about the anaemia, she literally ran out the door and arranged for immediate tests and since the blood samples that day had already been taken to the hospital, one of the practice nurses took mine up. Later that same afternoon, the doctor called me with the results. Fast, efficient, and my prescription was free. I was checked also for blood sugar, and called back when the results were a little high. Fortunately it was due to something I’d eaten just before, because otherwise I would have been called back more regularly and put on a special diet. She also sent me for NHS homeopathic treatment many years ago.
Thank you for the original post – and commenters for their own experiences. I do hope this gets through to where the loonier lies are being spread, and that it “goes antibody” (it’s the lies that have gone viral).
But in a way, this is all rather beside the point of the main American debate. As I understand it, no-one seriously proposes something like the British NHS for the US, and I can quite see why.
The NHS is the product of its time, the high point of belief in community spirit and collective action through the state for common objectives: that was, for my parents’ generation, what won the most threatening war in our history.
It was also, crucially, the time between the introduction of antibiotics and the development of ever more expensive hi-tech medicine for hitherto fatal/terminal/untreatable conditions. People genuinely believed that once the backlog of previously-untreated conditions had been cleared, the cost would go down as people got healthier.
The US is culturally and geographically far bigger and far more diverse to impose a single delivery system on. I suspect it may suit the Republican naysayers to have a gigantic row focussed on the British NHS, rather than have to discuss universal systems that nevertheless include some element of insurance + co-pay, as elsewhere in Europe.
Maybe, if we in the UK were starting from scratch now, we would have something very different. But the core principle, that “I am my brother’s keeper”, would still apply, I’m sure.
As it is, for many of us now, this is no longer an issue about healthcare but about something culturally important to our sense of ourselves. What the Sarah Palins and Investor’s Business Daily and people like that are doing to us is what our spitting on the Stars and Stripes would be for Americans.
Autolycus, I was trying to put my finger on why I’m so outraged by the misinformation about the NHS and you’ve done so in your last paragraph. These principles are so fundamental that when Fox News and the like attack them, they may as well be launching a personal attack on millions of British citizens. We feel personally slandered by the lies which are being spread. Spitting on the Stars and Stripes is a very good analogy.
If lies have to be part of the campaign, please could the American right stick to domestic American lies and stop slandering the four countries of the UK?
I’m in a very similar position to you and will sing the NHS praises… in fact, thinking of directing some traffic your way from my facebook for people who are interested.
Very nice article and I like the caveats you put around your opinion. Some of the comments here I feel are a little biased based on things people have heard of extreme right wing people in the US
[...] Most people in Britain cant believe some of the so called "stories" about the National Heath Service being quoted in the US healthcare debate. Stephen Hawking has never used anything but the NHS for treating his ALS disease for over 30 years. http://www.telegraph.co.uk/news/worl…t-the-NHS.html Heres a US woman who has experience of both the NHS and US healthcare and gives a balanced view of the good and bad points of both systems. A lot of other US users of the NHS also comment on their experiences of the system. http://potentialandexpectations.word…thcare-system/ [...]
Great article and I live how unlike most people you caveat this as YOUR experience and not representative of the entire system.
It seems though some of the posts here may be a little biased based on the comments of the FAR right and I don’t believe they are representative of the majority of conservative. It is a shame that it is generally impossible to not get a story that is slanted.
In my opinion the idea of healthcare for everyone is a great thing (don’t know if its a RIGHT of the people) but the idea of OUR gov’t (left or right) running it scares the hell out of me and not sure something I can commit to.
As a British citizens living and working abroad on a short term contract our son was born with a serious congenital heart defect not covered by our private medical insurance. Our first thought was the cost!! We took him home and received the most amazing care from the NHS. He is now a thriving 16 year old.
The NHS is not perfect but it does provide care and hope for millions of people. The people that work within the NHS are hardworking, kind and generous with their time. I’m glad people are starting to appreciate what we have in this country.
Taking care of people is the NHSs business – so lets make sure it stays that way!
Thanks so much for this post, and if you don’t mind I’ll be e-mailing the link to family and friends, as well as posting it on my facebook page.
I used to live in Florida, now I live in the UK, in Wales. While living in the States, I got really ill when I was an undergrad. I had to have MRIs, CTs, blood tests (galore), electromyography tests, you name it I had it. My parents did not have health insurance as they couldn’t afford it, so I was left without it as well. Instead of racking up student loan debt (which I did), I also racked up medical debt to the tune of $22,000, by the time I was 21! I got a job at a newspaper and (finally!) had health insurance. It helped, but putting down $50 for a visit to the doctor each time and only having the insurance company cover 20-40%% of blood tests and other tests, didn’t really help out. Not to mention that the insurance provider was dictating the doctors that I had to see based on in-network and out-of-network deals.
Because I had so much debt, and my income couldn’t match the payments, I dreaded picking up the mail each day, for fear of another letter telling me that I needed to pay up or else! I was working full time, and had a second job as well, and STILL could not pay off the medical bills fast enough. This did not include medicine that I needed each month, which cost about $1500. I resorted to sending away to Canada for my meds, which cut the cost by half!
Finally, five years later I was able to pay off my last blood test. I was offered the opportunity to pursue a PhD in the UK and I jumped at it. I knew moving here, I wouldn’t have to worry about healthcare, and quality of life is more important in the UK than the almighty dollar.
I’ve been here now for nearly four years. In the last year, I’ve had some issues come up, a broken foot (waited an hour in the ER, got an X-Ray, diagnosed), no BILL. I was actually scared to go to the hospital because my last experience of a hospital was in the States when I was rushed there after an episode by a friend. When I came to, I got yelled at by the registration nurse because I did not have my checkbook with me and could not pay the co-pay of $100. The hospital threatened to refuse care, that is until the episode flared again, and they were legally obligated to look after me.
In the last six months here in the UK, I have seen my doctor 8 times (no cost), had four sets of blood tests (no cost), had a pelvic ultrasound at the hospital (no cost), seen a specialist at the hospital (no cost), been on 3 courses of antibiotics (no cost) and two other medicines (no cost) and have been called up specifically by my doctor’s surgery to encourage me to have a cervical smear, which I had (no cost).
I am not a British citizen, yet the British medical system has welcomed me into it and has offered to look after me in my hour of need, something the American health system has never offered.
I have one year left on this PhD. Am I coming back to the States? NOT A CHANCE IN HELL.
Just wanted to say that this story was incredible. I’ll be forwarding to all my friends and family, especially those who do nothing but parrot right-wing talking heads about Britain’s death panels and bankrupting socialized medicine. Thank you!
By the way, to Americans wanting to see an NHS system of our own (even if it’s not as extensive as Britain’s) if you’re on Twitter, you use the tag #WeWishWeHadAnNHS and say why.
Finally, I didn’t notice this anywhere on the page, but you can Digg this story at http://digg.com/political_opinion/An_American_s_experience_of_British_vs_U_S_heath_care (it already has diggs)
Hi back again – thought I’s like to share some macro indicators.
At present, the USA spends around $6800 per person per year on health care.
The UK spends around $2800 per person per year – less than half the USA amount.
Put another way, the USA spends 16% of GDP on healthcare (and rapidly rising), the UK around 9% GDP.
For that, we get 100% of the UK population covered. The USA has 46 million citizens without health insurance (and those figures seem to be getting worse).
Life expectancy in the UK is higher than in the USA. Birth mortality rates are lower in the UK than in the USA.
These figures seem to suggest the NHS is a massive bargain for the UK: truly, a system which is hugely more value for money than the current US system.
I Love the NHS!
Without it for sure i, my father and mother would not be here today for various reasons over the years!
I live just outside london. Anytime i need to see my doctor i can usually get a same day appointment. Ok so you may have to wait a little when you get to the surgery but at least it gets me out of work!!
A few years back i had a very bad smear test result, i was told that if i hadnt been tested it was likely that i would have had cervical cancer within the year. I received my treatment with no problems within two weeks. I have private insurance as well but the waiting time and consultants would have been the same so i stuck with the NHS. I have since had normal tests back! woo! and i get tested every year!
I have recently got back to the uk after travelling around the US for 6 weeks. I couldn’t quite get my head around seeing a man in santa monica begging on the street because he couldn’t afford to get a much needed operation on his hand. Or the amount of people walking around talking to themselves obviously in need of mental help!
I fell ill while in Texas with bronchitis, i often get this in the UK but this time it cost me $600 to see a doctor and get my meds which i had to put on my credit card until i returned to the uk to claim it back from my insurance which in itself took a lot of paper work and waiting time! At this point i realised how lucky it was that i brought my credit card for emergencies and to live in the UK and have the NHS !
Typing as the wife of theproseandthepassion I feel the need to comment. I am near tears when I think of the injustice of paying private insurance only to be turned down for the treatment you require!
I am fiercely proud of the NHS. IT has always been there for me and my family. I had 3 midwifes and 2 paramedics at my sudden, speedy and unplanned homebirth. The result? A perfect baby girl, a healthy mum and NO BILL!!!! (Except for the replacement carpet trashed as a result of the birth which was paid for by our household insurance!!!)
It is not a perfect system but which system is? You pay your taxes (like my husband) and you get your healthcare…oh and even if you don’t pay taxes (like me…at home rasing my two small children) you STILL get your healthcare. SIMPLE!
My Father needs a cocktail of 13 different tablets every day to still be here! As he quipps he should rattle when he walks. He pays for his prescriptions in advance for the whole year which offers him a big discount on the individual prescription of £7.10…I can’t remember how much it costs him but it is very reasonable…£200 a year? He can see a GP when every he wants. He is regularly monitored by his Cardiologist. He receives free physio when needed and attends a free keep fit class once a week specially designed for a person of his age and physical ability with his medical background (he is 78).
My Parents aren’t wealthy but they have always paid their taxes and that has provided them with all the healthcare…ALL the healthcare… that they have needed. Without this I would have been fatherless long ago. My Dad is fantastic and we love him, especially the two little girls who would never have know their Grandfather had it not be for the British healthcare system! Thank you NHS!
Another advantage of the UK system – not directly relevant to the argument – is if you go on holiday in Europe you are entitled to free or subsidised medical care in 28 other countries if you apply for a free card: http://www.ehic.org/cover.html.
Very well said! I’m another expat who has had experiences in both countries. I was made bankrupt in the US by medical bills when I was 21yrs olf age – and my life was dictated by trying to pay for medical services & presciptions. (Working 3 jobs simultaneously is no way to live to get health care!)
I’ve been living in the UK for over 20 yrs and thank my stars for the NHS! I’ve had surgery here (suspected breast cancer) and from the 1st appt with my Dr – I was on the operating table 5 days later! I also get monitored at one of the leading cancer hospitals in the world for follow ups. My son suffers from a rare disease and sees a specialist in one of the top hospitals in the world – Great Ormond Street Children’s hospital. Inhalers & presciptions for my husband are affordable… Nothing in this world is perfect, but by all accounts – it works and I’m no longer hesitant about booking a Dr’s appt for myself or my kids because I’m short on money!
Great article! I too have had experiences of both systems. Whilst on holiday in New York I came down with a severe case of gastric flu. After stuggling to see the sights for 3 days I could see no more and had to take to my bed. The hotel recommended that I go to the local ER rather than call a doctor.
The hospital was no cleaner that any I have experienced in the UK. The cubicle I was presented with was filthy and the first set of questions I was asked concentrated on my ability to pay.
I was taken care of, the doctor did his diagnosis and a saline drip was duly administered. I laid there for 2 hours. Was discharged, ushered towards the cashier and prompted to pay $300. On my return home a further bill of $150 for the doctor’s services was received. My travel insurance thankfully took care of these. The care and the environment in which it was delivered was no better than that I have encountered through the NHS.
The NHS is not perfect but I could not imagine what those without insurance have to go through. We are lucky that when we need to use healthcare ‘money’ or ‘ability to pay’ do not have to be considered nor does the worry about having to have time off work.
From my brief time in New York healthcare seemed to be a major private industry, pharmacies on every corner, adverts on tv for drugs! It is an industry here it is a service.
To me a major issue of the the argument seems to be focussed on the loss of individualization and a fear of anything ’social’. Those in the UK and in Europe have been brought up with taxes and national insurance-I do not mind paying towards other peoples’ healthcare, the education of other peoples’ children, the state pensions of my parents’ friends nor the prescriptions of those who can’t afford to pay them themselves. In fact I would pay more in taxes if it meant better services it is after all my duty as a responsible citizen!
Thanks for this, which is the first thing I’ve read on this subject in days that hasn’t depressed me.
Your article is clear, thoughtful, intelligent, cautious… all the things that the recent debate has not been. All in all, you make a very powerful case for British pride in the NHS without anywhere legitimizing British complacence.
I write, by the way, as a British citizen living in the U.K. who has an American partner. I love America and I love my American family; I’m also aware of the failings of the NHS.
Nobody in Britain expects the United States to model its healthcare on the NHS, as if other countries should learn from our successes without also learning from our mistakes. All the same, I think Britons are getting tired of something we greatly value being hysterically misrepresented. Your comments are apposite and welcome.
I grew up in the US and have been in the UK for the last five years.
From the age of 18 to 25 I was uninsured in the US. I was a student and/or a person with a low income for that entire time.
I am at risk of breast cancer because my mother died from it. When I was 22 I discovered a lump. I couldn’t afford to see the doctor, so I hoped it would go away. A year later it was still there. Through some Google searches I discovered a breast health clinic in my area for low income women. I was told that they would pay for a biopsy and mammogram because my income was so low.
I had the tests done and was told the lump was benign, for now, but that I should get it checked again in a year to see if it had changed. I also got a bill for several hundred dollars, which I spent a great deal of time disputing and eventually they agreed to pay it like they had said they would.
Fast forward a year. I still had no insurance, and a lump. I couldn’t afford to do anything about it, so I went back to hoping it would go away.
I moved to the UK in September 2004. In October I got registered on the NHS – I was a student on a program lasting more than 6 months, so I was eligible for NHS treatment, even though I’d never paid a penny in UK taxes. In November I went to the GP about my lump, at the urging of a British friend. Within a week I was getting another mammogram and biopsy. Free. A few days later I had the results – it had gotten bigger, and they recommended that even though it was still benign, I should have it out. (The choice of whether to have it out or not was up to me.) I was offered a surgery slot for early December, but I opted to wait until my university holiday period in February so I wouldn’t miss too many classes.
February. I got outpatient surgery and the lump was removed. Completely free. I could never have afforded it in America. I didn’t even have a doctor to ask about it in America!
In 2007 I had x-rays and physiotherapy for a hand injury – free. Last year, sadly, I needed and got emergency treatment and aftercare (scans, blood tests, consultations) for a miscarriage. Free.
Contrast this with my friend in Utah with whom I stayed during the year before my move…her two year old daughter was running in the back yard, holding some pencils, and fell against the steps to the house. She hit her head. When she got up, crying, she had a bloody nose and a cut lip, and we also couldn’t find the tip of one of the pencils. I was worried that it had become embedded in her nose.
My friend could not afford to take her daughter to the doctor, so she comforted the child as best she could, and then…like me and my breast lump…she hoped the problem would go away.
Hope is a great thing, but it should not be the only medical option for anyone. If you are in the US, please don’t be swayed by the anti-change propaganda from the insurance companies. Read everything that you can get your hands on, and make up your own mind. When you see your friends spouting propaganda, teach them what you have learned.
In the US you have to pay to even go to the doctor?! That’s obscene! I really, really don’t understand the mentality that tolerates such a situation.
I must say, as an American that is so frustrated with the level of stupidity coming from the ring-wing conservatives, I am glad that someone has presented the facts as they have experienced. I just wish there were more of these facts coming out. I have linked to this on FB in hopes that more people will read this and learn the truth.
Thank you for taking the time to write this.
Thanks for a beautiful and well written piece.
How gullible are most of you! How much does this NHS cost? You make it sound as if it is free health care. If you add all the taxes a middle class family pays, you’ll realize it would be twice as expensive as the US. Isn’t it immoral for someone who doesn’t pay any taxes to get free health care? In any NHS, paid for by tax payers, the more money you make, you’ll end up paying more for health care. Is it fair for someone to pay $100,000 per year and receive the same coverage as someone paying $0? What if you are not satisfied with your NHS – what choice do you have? US needs health care reform but not public health care and definitely not NHS
So you’ve managed to read this far, all these comments from both British and American readers heaping praise upon the NHS, and you can still think we are ‘gullible’. As has been stated several times, the NHS costs roughly half per person what the US pays on healthcare, yet provides coverage for all, rather than for some. It nauseates me that you seem more concerned about money than human beings.
‘Isn’t it immoral for someone who doesn’t pay any taxes to get free health care?’
No, it isn’t. What is immoral is a system which leaves people without healthcare because they can not afford to pay for it.
‘Is it fair for someone to pay $100,000 per year and receive the same coverage as someone paying $0?’
If someone is paying $100 000 per year tax they are a rich person making a lot of money. They should be grateful for their good fortune. In the US some of their tax already goes towards Medicaid and the like. Of course it’s fair. They are making a great income. They can pay for private coverage if they want to.
‘What if you are not satisfied with your NHS – what choice do you have?’
We have private healthcare options, but most people see no need for them. The NHS is so good that private healthcare is generally seen as a waste of money in the UK. If we are not satisfied with the NHS we complain, either directly to the NHS or to the government. We pay through our taxes. The government serves us. It has to answer to the voter. Corporations answer to shareholders. In the UK we are not so gullible as not to know which is in our best interest.
Healthcare is a basic human right, not something that should be mandated based on how much one can afford to pay! I can’t believe I’m reading this heartless diatribe.
If I earned £100,000 per year I would gladly contribute for coverage to people who earn nothing, because I’ve been in that situation – I still am – and I know how grateful I am for not needing to pay for my medications. If I did, as someone with no earnings due to chronic ill health necessitating I be on our equivalent of welfare, I’d be on the street and heavily in debt even then, because in the US my meds would cost me $24,000 per year!
Ever hear of “the milk of human kindness”? Would you want to be on the street ill and receiving no treatment if you couldn’t afford to be insured? Of course you wouldn’t, so why not show some of the same consideration to the people in your country who are?
Strawberry I just wanted to say you are getting more responses on your post about US Healthcare then the Guardian. You really should get paid for this. God Bless you for getting the ball rolling. There are many of us who try to express our own experiences but somehow not as well as you. You keep the reader reading.
Another thing which just came to my mind that irritates me about the private healthcare system in the US is the fact that companies can exclude the long-term unmarried partners of their employees (for BOTH gay and straight couples) from coverage under private insurance policies. For heterosexual couples, this can easily be solved by getting married – yes, what a great reason for marriage! – but for homosexual couples it’s not nearly so straight forward. I personally prefer a system where every man, woman and child is treated equally.
Thankyou for writing this. Id like to echo steeveetee, a well writeen piece. I’m a Brit who’s fascinated by the current healthare debate in america. You may be aware that the republican attacks on the NHS is currently making headlines in the UK. It’s going to bve interesting to see how all this plays out in america and how it could affect the british general elections next year.
Well said Strawberry. And thank you. And thanks to the internet. People can pass on e-mail links and twitter and blog to counteract the lies spread about in the U.S. about Britain’s health care system.
There are may lies told about health care in England. I fall about laughing when I hear stories about us supposedly pulling our own teeth or cleaning our own hospital rooms. Its all nonsense. Unfortunately it seems, Americans especially seem to believe them.
America will not get an NHS like system because Americans are prejudiced against their government. Its in their blood. In Europe we do pay higher taxes but we do get some excellent services and at a very good price. Here’s an example from last Sunday afternoon.
Sailing with some friends one of our party (the youngest in fact, only 32 yrs old) had a seizure and lost conscience for quite some time. He has no history of seizures and although he has a very bad health problem this did not seem to be connected. Being 20 miles off shore and about a hundred miles away from the nearest main hospital we called the emergency services who in turn called out both the medihelicopter and the sea rescue service. We headed straight for the nearest harbour. A speed boat with 6 crew (4 male and 2 female) came up alongside after a while but happy that he had regained consciousness and that we were making good speed they raced ahead and made plans for our landing and for the helicopter. The helicopter arrived soon after us and the team checked our friend over and then took him to hospital where he was held overnight for observation before being discharged. The most he will pay for any of this is about 32 euros for the overnight stay. I think in England it would have been free. The helicopter call alone probably was worth about 10 000 euros. The Finnish national government will meet the cost of the immediate recsue services and the local community will pay for the hospital check up and his overnight stay.
Our societies do this because we care for others as we would wish to be cared for ourselves. Nothing less. Costs are mostly shared across the whole of society. We pay taxes when we are healthy to receive care free when we need it. Rich or poor, working or retired – they are all treated the same. Its what we should do. And its what governments do best. Uniform services for everyone under democratic accountability.
I find it hard to think that some people think differently.
“There are may lies told about health care in England. I fall about laughing when I hear stories about us supposedly pulling our own teeth or cleaning our own hospital rooms. Its all nonsense. Unfortunately it seems, Americans especially seem to believe them.”
With good reason I’m afraid, in the case of the guy pulling his own teeth – it was entirely genuine, rather than the “nonsense” you would like to believe. It may well be unusual, but it did indeed happen, and was actually well documented here in the UK at the time.
It’s probably confusing the issue to bring UK dental care into the debate. In the 1980s Mrs Thatcher’s Conservative Party government semi-privatized UK dentistry, so dental care in the UK is only partially covered by the NHS. Thus, stories about its ‘failings’ possibly have closer parallels in reality to the failings of the virtually fully privatized US health care system.
Well I did not say that the story about the guy was not true but just that it is funny. It makes it sound as though one cannot find a dentist to pull teeth. And (if you live in the UK as you seem to imply that you do) then you’ll know that finding a dentist is easy. All you need to do is pay, same as they do in America! Any person who pulls his own teeth using pliers because he won’t pay for a dentist has a problem much higher up in his head.
The issue is about NHS dentisty, and of course many dentists prefer to do private work because it pays better. My own experience of dentistry in the UK, private or NHS, is that it has the same faults as the US system; it is fee-for-service. Which means that a dentist only earns money if he or she does something. I once visited a new dentist for a few years and after years of being told that my dental health was near perfect the new dentist started telling me about holes and teeth that needed filing down. She did several fillings, all at the top and ground my teeth (one of which eventually cracked and had to be crowned). After spending several hundred quid with this woman and being told that there was another problem that needed work I decided to get a second opinion. And there was NO PROBLEM. She was doing work just to empty my pocket and put it into hers. I was horrified. The sooner we get NHS dentists paid a salary and doing work for the public and not for themselves, the better I will feel.
America has the same problem in health care. It has way too many specialists (in heart surgery for example) because specialists get paid more. But guess what. Americans have much more heart operations than people in other countries. That is scary.
I should have added to my earlier comment that I am a Brit now living in Finland. The health care system here is much the same as in England except there are small co-pays for doctor visits and for hospital care.
[...] This American’s Experience of Britain’s Healthcare System « Potential… [...]
My daughter, an American, lives in Scotland with her (Scottish) husband and daughters. Her experience is very much like yours, and I so appreciate your having taken the time to elucidate all of this. I wish I could understand the vitriol and fear that this debate brings out in Americans, but we are so overdue for a change! I’ll be linking to this far and wide.
Thank you for your excellent report on the NHS.
I find the level of debate on this issue unbelievably poor. It scares me that supposedly inteligent people can be so ignorant and irrational about such an important issue.
I was born in the US but have spent the last 30 years living England and have experienced health care in both countries. I have been under treatment for bowel cancer and secondaries for the last 18 months in the UK under the National Health system.
My treatment under the NHS for cancer has been superb. The doctors, nurses and other support staff have all been supportive. Not only to me, but to my family as well. With cancer, the patients family sometimes need more support than the patient dealing with the disease. And this support has always been there.
I have had chemo with 3 different drugs. Failing to tolerate the first 2. I’ve been in hospital twice in the UK and once in Spain for chemo side affects. And require 3 operations, 2 for tumor removal and one for a reversal of my illeostomy. I haven’t had to pay a penny for any of this treatment.
In addition to NHS care I also have private health insurance here in the UK. My private insurance excludes any pre-existing conditions and is very expensive. The NHS is always there for any treatment I require whether pre-existing or not.
All health systems have limited funds to work with and some form of rationing takes place, whether it is by your insurance company or by the NHS.
Based on my experiences of both health systems, there is no way I would choose to be treated in US under its exisitng system over the UK,
If you can afford Healthcare in the US i’m sure its the bees knees, the problem lies with those who can’t.
The NHS is not without faults, and i could probably afford healthcare if i was in the states, and perhaps because i can afford it, it would increase my life expectancy by 2 years.
Even with those options there, if they were written in stone live to 76 in uk, 78 in the states. I’d still pick the NHS.
We should judge our society on how we treat our most unfortunate, this is where the NHS wins all the gold stars.
And for a religious country like the states, i think that do unto others as you would have done onto you should be key.
We cannot predict the future, our kids might not be so fortunate to recieve health insurance, they might have a long term serious illness that wrecks their jobs, lives, and finances.
The World Media like us to live in fear, if the future well being of our kids isn’t the scariest thing possible, what is?
[...] This American’s Experience of Britain’s Healthcare System « Potential and Expectations When I lived in the UK, I railed against the NHS (the National Health Service). I cursed every delay, every perceived inconvenience, every way it differed from the care I had received in the US. But I moved to the UK only a few months after graduating from university and, until then, I had been covered on my parents’ very generous insurance so I had experienced American healthcare only as a dependent. I was judging my British experience from a lofty and privileged position of someone who’d always had gold-plated insurance. And I was naive, because I’d never had to pay for it, never had to worry it wouldn’t be there, never really had to deal with the paperwork. I never really understood what I was comparing the NHS to at all. (tags: usa uk healthcare nhs debunkingmyths medicine) [...]
Thanks for writing this. It’s a very interesting, well-written comparison of the two systems, albeit (as you say yourself) based on personal experience. One of the most important points you make is that you can’t decide between the two systems based only on anecdotes, which is what is often happening in this debate (and I’m guilty of this myself – tweeting all the ways the NHS has helped me and my family). But, I do think that people who have experience of both systems (which I don’t – have experience of health care in the UK, France and Spain) can give the best personal perspective on it.
Thank you for sharing your experiences.
I had my gall bladder op for free here in the UK. Yet have a friend in the US who had to sew her oen cut arm up as she had no money!
I know which i’d prefer!
I never even think about it. If i need medical attention, or perhaps just want to talk to a doctor, i go see my doctor that day. All treatment is free, all medicines are free to the majority or a nominal charge for the well off, i can choose where, who with and when i get my treatment. If it’s an emergency i just turn up, or get a free ambulance ride to nearest hospital.
Here’s the US system…
http://video.google.co.uk/videoplay?docid=6646340600856118396&ei=WLiFSuaoGMbC-Abvn_mvCw&q=sicko&hl=en
… i’ll take the NHS every time!
[...] http://potentialandexpectations.wordpress.com/2009/08/13/this-americans-experience-of-britains-healt... [...]
Julie Boddy,
I think your point about how the uninsured are covered in the USA is very important and deserves to be emphasized.
The people standing around in the US waving the placards saying “no to socialized medicine” do not appear to understand that a system of “socialized” medicine already exists in the country. Under the existing arrangements, when someone who is uninsured is treated, whether it is by a hospital who have a policy of treating the uninsured, or whether it is due to someone showing up in ER, the hospital ends up with costs for treatment on its books. If the hospital does decide to attempt to recover those costs, and the person cannot afford to pay, that person ends up bankrupt and the debt is written off. The medical institutions have to recover these costs somehow, so the fees end up being added onto the fees of those who are insured and who do pay for their treatment.
Secondly, if I understand correctly, healthcare payments are taken off the top line of your salary before taxes are deducted. That means the US government is providing a tax subsidy to healthcare costs. In other words, the government pays for part of your healthcare.
My reading of Obama’s legislation is that he is essentially regularizing what is already there. As a very gross simplification, instead of the medical system(s) paying for the uninsured by writing off their costs, and instead of the government providing subsidies to insurers, the money is instead to be paid into a central insurance fund which will meet those costs instead.
I noted some comments above (especially from Sarah) where people received bad treatment from the NHS. It’s very important that those of us who are NHS advocates resist the temptation to try to wallpaper over these criticisms. Failings like those described by Sarah are very serious. In many cases they are caused by bad management or, more often, underfunding. The NHS does as well as it does with a relatively low degree of spending. I wonder what it would look like if we funded it to the same extent as the French and the Americans do.
[...] This American’s Experience of Britain’s Healthcare System [...]
I have little personal experience of American Health System except that my son moved there and we had to find a health policy to cover his first year. That was a nightmare. Here there are no worries. Friends have moved here from abroad and as soon as they are registered for work can get a GP and they are away!
My son has a friend in USA who sold his house to buy 2 months of medication for his liver transplant. His wife lost her job and they have small children. They now have no money, no prospects and no hope. In two months… I can hardly dare think that far ahead. How can any sane American prefer their system to ours where he would have the medication he needed for life without losing his house?
Another American friend died of cancer recently because of the costs involved visiting a doctor. By the time they went they were too ill for treatment. It was such a waste of life.
We Brits just do not understand.
Yes, we have problems, but I would far rather live with them and campaign to improve things here than live in constant fear of not getting help when I was sick.
We have seen documentaries about charities providing healthcare to the poor in the US. These were set up to work in 3rd world countries. We cannot understand why the rich Americans interviewed have no feelings of shame when their fellow countrymen have to resort to charities that work in poor countries for basic healthcare.
Can anyone explain why they seem to have no compassion. I am sure they are not bad people, we just cannot fathom it out.
Thank you for writing this so well! I’m an American in the UK as well, and before I moved here, I used to work for a hospital in the US–in the department that tries to get the insurance companies to put doctors on their panels so the patients’ claims will be paid. It is a logistical nightmare, and I wish the people who claim they don’t want beaureaucrats between patients and doctors could really see and realise how many people are there now! And because of the hospital’s mission, we didn’t turn away people who needed help even if they couldn’t pay–which meant less money for new equipment, for new doctors, for cutting-edge technology, all the things that would help patients! (Here’s irony for you–I started out temping for that same hospital, and had no health insurance. Within that month, I had a horrible sinus infection and a badly sprained ankle that required me to walk with a cane. Even though I worked in a hospital, surrounded by very good doctors, I had to hunt around for a free clinic that could get me in because I had no insurance at the time and there was no WAY I could pay for even so much as an Urgent Care visit out of my own pocket. One of the clinics is run by the very same doctors, who take their healing oath seriously enough to volunteer their time and service for those who can’t afford care otherwise. But that is the exception, rather than the rule, and most towns are not so lucky.)
I have also heard that “anyone can get the care they need if they go to the ER.” Well yes, this is true-but they still have to pay for it, just not at the time. When the bill shows up later and it’s $900 for a painkiller for a tooth infection (which one of my friends in the States recently had), what do they do? Go bankrupt? Skip out on the bill? If they don’t pay it because they can’t, the hospital has to eat it, and then we’re back where we were.
What good is the best care in the world if it’s not accessible? And look, people die in US hospitals, too. Doctors everywhere are not gods, they are not perfect, and House is a fictional character. No system is not run by human beings. Working in health care I’ve heard some brilliantly inspiring stories but plenty of heartbreaking ones, and not everyone actually thinks they did get the best possible care when they needed it–in ANY country.
So I’d take the NHS, too. My doctor’s office is right down the street. It never takes long to get an appointment–definitely faster than back in the US–and they’ll cover things that I could never manage to get approved before, even on the best insurance plan I ever had. It took only a few minutes to get my allergy medicine–and the kind I wanted that really works, not the kind I’d been forced to use back home because it was on the approved drug list even though it wasn’t very effective. Since I live in Wales and the devolved government has chosen to spend money this way, the prescriptions are also free, so whenever I am ill, my greatest worry is whether I have the energy to walk all the way to the surgery–not whether I’m going to have to drop out of grad school and spend the rest of my student loan on medical care.
I agree with the comments that point out that many of these stories are purely anecdotal and that every system has its pluses and minuses. So I thought I’d share my story, which isn’t exceptional but merely average. And the end veers past the anecdotal to the facts on the ground.
My whole life, I had been on health insurance through my father’s employee insurance. My mother worked in a local hospital, which benefitted my care as I was an active but clumsy child. Even up through university, I remained insured through my parents and received average care. I was able to see a doctor whenever necessary. Sometimes the doctors were amazing, like when I was diagnosed with pneumonia for the third time just through a stethoscope. Other times, the doctors were less than stellar, such as when I got blood work done to look for a serious virus, which they forgot to test me for but hey, did I know I was anemic (genetic condition listed on all my forms).
When I graduated from university, I moved to the UK to work for two years. Within my first week, my employer had filled in all the forms required for me to receive a National Insurance number so I could register with a GP in Cambridge. Since then, I had coverage. I went to the doctor probably every other month or so, whether for birth control check ups (free birth control, compared to the $30 I paid for the same prescription in the states, plus check ups every 6 months to make sure your blood pressure remains stable) or just for general aches and pains, coughs and colds, fevers, etc. Sometimes the doctors were great and helpful, other times not so much. But it didn’t cost me any cash up front, which I appreciated.
I will admit, like the author, I was pretty unimpressed with the NHS while in England. I was spoiled by the American system and couldn’t help but compare the two in terms of customer service and the like. But now I have just moved home as my contract ended and my visa expired. And now I miss the NHS, not because they were amazing but because they covered me. And here is where my story becomes less anecdotal.
I am a healthy 24 year old with no pre-existing conditions. I am currently unemployed but am searching for work while I apply to graduate programs. Within my first week home, I applied for a very very basic health insurance plan in California (which won’t cover me if I move out of state for work) that I can’t afford after a few months if I don’t find a job-but that’s beside the point. I have been home a month now and remain uninsured, but not for lack of trying. If I, a healthy young adult, have to jump through this many hoops and pay over $100 for check ups to prove my health, I can only imagine what other people are going through.
I know that each system has its strengths and weaknesses. I can recount both success stories and horror stories for the US system as well as the NHS. For me, the point is not which one offers the better care as that will always remain subjective. For me, it comes down to actually being insured. And no one in their right mind can argue that the US system is not broken in that regard.
Time ran out before I could finish your post, but I want to thank you for it. I’m an American trying to inform myself about how British and American systems actually operate, and what you’ve written is very helpful. It will help me inform others. I’ll return to finish reading your post later. Again, thank you.
At last, an American who has a half good grasp of it …… thanks for spreading the word.
Though don’t do it too much or we’ll have to deal with an increase in the existing health tourists !
Thank you for writing this post – and even more for inspiring some wonderful and insightful comments. I’m English, have lived here all my life, in various areas of the country, and whilst moaning about the NHS is a national preoccupation, there is no doubt that the standard of medical care is generally excellent.
From trips to Casualty for cuts and broken bones to managing a long term chronic illness and getting genetic counselling due to a family history of cancer, I have always had positive experiences with the NHS. And yes, at times you have to work at – make the extra effort to push for more time if you need it, or take a friend or a list of questions if you are receiving complex information – up to and including taking advantage of your right to request a second opinion or a change of practitioner.
No system is perfect – but I have always been assured that under the NHS, for me, my family and my friends, whether it is a minor issue, or a life threatening situation, the first priority is the medical care we need, not our ability to pay for it. I cannot imagine having a system where my father’s heart attack or my mother’s cancer diagnosis would not only have carried the fear and worry of them being ill, but also the fear that our family could be financially devastated by the cost of their care.
There are issues in England regarding the cost of long term care for older people, particularly in residential care – from some of the debate I have seen, it would appear that this issue is being confused with the NHS issue to make a politically convenient argument about end of life care and the way that decisions are made in the NHS.
“What about employer insurance in the UK? Almost worthless, in my opinion. Since the NHS covers nearly everything, a company has no incentive to offer a comparable plan. It’s only good emergency cover, and only for very limited kinds of emergencies. For my wife’s pregnancy, the only things they cover are the most extreme emergency problems that would probably result in a miscarriage anyway. Furthermore, private insurance often won’t kick in until AFTER you’ve gone through the NHS! For my foot injury, my company’s insurance company *did* cover the cost for a physiotherapist, but only *after* the podiatrist specialist would approve it. Because I was able to use it I went to see a private physiotherapist only having to wait 1 week (for the insurance papers to go through), but I still had to wait over a month.”
There’s something wrong with your UK insurance then. I work for the biggest private medical insurance company in the UK. If one of our members needs an ultrasound, x-ray, blood test or to see a specialist, as long as their GP’s ok with it we’ll cover it. PMI is worth it, because you get seen quicker, and get to stay in nicer private hospitals.
And my opinion regarding the NHS is this: The NHS covers our needs, not necessarily our wants. If you want more from your medical treatment (e.g to be seen quickly), pay for it using PMI or self-pay. Considering the NHS is free, that’s all you can ask for.
Laura.(Aug 14 posting) Does your company’s private insurance plan cover (a) general physician care (b) chronic care for things like diabetes, dialysis, obstructive pulmonory disease (c) pregnancy and labour (d) terminal diseases like AIDS (d) end of life care/hospice (e) birth control ? These are the things that most people will need in their life time.
My understanding is than private insurers have these on their standard exclusions list (according to the Association of British Insurers).
The private sector is really only interested in curative procedures. Yes you may get tests and get things like knee ops and heart surgery but don’t expect it to be much help if you have a chronic illness. And woe betide if things go wrong during an invasive operation (or after) because those hospitals are NOT geared up for handling emergencies. Its only NHS hospitals than can be sure of having all the specialists on hand or on call and sufficient stocks of blood and plasma on hand if things go badly wrong. It can and does happen that people are sometimes put in an ambulance in the private hospital and whisked away to the nearest NHS acute hospital.
Personally I would not swap the clean vinyl floors and the four-beds-to-a-ward NHS hospital for the vacuumed carpets and private rooms in a private hospital. I have seen both and had treatment in both. I am not fooled by the false sense of security when met with a hospital reception looking like a hotel with its flowers, carpets, comfy sofas and table lamps.
Moore uses some great visuals to illustrate just how crazy the American system is. Hysteria
When they first began to privatize hospital cleaning in NHS hospitals in the early ’80s, in order to make a profit, the private firms cut back on cleaning –the beginning of a down-hill spiral in terms of hygiene and disease prevention.
On another issue, it’s actually the case now that, if you look beyond the American Medical Association, which no longer represents the majority of working doctors in the States, most physicians are in favor of a single payer system. Look at the campaigning of Physicians for a National Health Program. So are major nurses organizations. So, too, according to many polls, are most citizens.
What’s needed is a well-organized grass-roots campaign to assert our collective need for a national health system.
Thanks for your cool, calm and collected comments – a dose of much-needed honesty and reality amongst the innuendo, hysteria and downright lies being broadcast as part of the healthcare “debate” over past weeks.
I am a Brit – now living back in UK but was working in the States for five years. I had good healthcare insurance in the US as part of my employment – but I often shuddered at the thought of coping “outside the system”. Where I lived (urban area – large Afro-American and Hispanic population) I saw a lot of people who obviously lived on the margin – and often wondered how they coped when kids and/or elderly relatives got long-term sick, etc.
I am now back in UK – and have recently discovered what it is like to suffer a chronic illness myself. I have developed heart disease and both the physical and mental burden of coping with this in what I thought was the “prime of my life” has been exhausting and driven me at times to the end of despair. But what keeps me going – apart from support of family and friends – is the kind of care I have received from the NHS. Every day, I thank God that I was home when this happened. I am stabilised now, and attend a heart failure clinic on a regular basis at the regional NHS cardiac centre – one of the best cardiac centres in the country. I also have great support from my GP (local doctor) and can go to talk to my doctor anytime about my condition/worries, etc. If I had to fight the bureaucracy associated with “being sick” in the US (copay, worries about amount of coverage, etc), I don’t think I would have survived the acute stage. I would have given up by now. Oh, and finally – this comment is directed towards Fox TV and some of its recent disgraceful, irresponsible “debate” – I was first diagnosed by a foreign (Muslim) cardiac physician working in the NHS system. Everyone else up until that point (including me) had thought I was having a gallbladder attack (a pre-existing condition). This calm, gentle man was called to my bedside in the middle of the night, when my heartrate was accelerating towards 190, and I thought I was drowning in my own body (an experience associated with severe pulmonary oedema). He quietly held my hands, told me not to panic, and ordered that I be put on appropriate IV medication etc. immediately, until a cardiologist consultant could come and examine me next morning. From that night on, I knew I was in safe hands – if that “foreign doctor” was also a “terrorist”, I frankly couldn’t give a damn. That decent, caring human being started me on the road to recovery. Extreme right-wing America, please do not knock the UK health system and the majority of people that work in it – you don’t know enough about the reality, nor are you courageous enough to find out. Shame on you and the worthlessness of your (over-loud) political expediency. I am so so glad I followed the signposting to the comments on this post – and found that decent, honest America is still out there and willing to stand up and be counted. Let’s have a mature, honest debate on healthcare reform moving forward – based on facts, not innuendo and lies. Keep this going! Good luck.
JUST LOOK AT THIS:
http://www.guardian.co.uk/news/datablog/2009/aug/12/nhs-us-healthcare-obama
Sums it up.
NHS is better ALL round than the US Health Care.
I actually feel sorry for Americans, they are, simply put, the most un-free citizens anywhere. American’s get all their knowledge from TV, so if they believe all the well funded TV adverts Briton’s must appear like a third world country… couldn’t be further from the truth. I’m a Conservative Party member, do not think Dan Hannan represents the majority view!
EVERYONE, NO MATTER HOW OLD, NO MATTER HOW EXPENSIVE, GETS FREE HEALTH CARE.
ANY CASES CONTRARY TO THIS ARE FEW IN NUMBER AND NOT REPRESENTATIVE OF THE NHS AS A WHOLE.
THE NHS IS CHEAPER & MORE EFFICIANT.
End of.
I’m from the UK.
When I was a penniless student I was diagnosed with a brain tumour and other related head fun. Givenmy circumstances, I wouldn’t have had insurance if I was in the same situation in the US – or at least nothing worthwhile.
I must have had 20 MRI brain scans now, spent two weeks in hospital (inc 5 days in ICU) and underwent a brain surgery. God knows what that would have cost on the open market – but to me, it was free, as are my on-going check-ups.
Sure the NHS has problems. One time a junior consultant read me someone else’s scan results, for instance. And my GP was treating me for exam stress in the run-up to me being diagnosed originally cos she couldn’t see past my impending finals as to what was causing my headaches, and I had no option to get a second opinion.
But the fact is I’m alive to be gently annoyed by the NHS’s foibles. I almost certainly wouldn’t be under the US system (or if I was I’d still be paying the bills off ten years later).
People criticising the NHS and dismissing it wholesale can come argue with me if they want to.
Thank you so much for this balanced and well thought out blog. I have pasted the link on Facebook.
I am a Brit currently living and working in in Texas and I have been horrified by the lies and propaganda currently being spread in the US about the NHS. Whilst I have had nothing but positive experiences so far with the various healthcare providers i have encountered here in the US, I know that I am lucky to be able to (just about) afford healthcare and that I have the facilities and knowledge to access the correct information to enable me to shop around to find myself the most suitable insurance at the best price.
The American healthcare system is just about fine if you are an educated, middle class person with a reasonable income. In my case it is still a financial struggle for me to do so and with all sorts of pitfalls like deductibles and co-pay I am only inclined to visit a doctor or dentist if I really, really have to. I know plenty of people here who simply cannot afford insurance and therefore simply do not seek any kind of medical help when they really need to.
So many people fall through the cracks in the system here. A close friend of mine had cancer when he was a student in in his mid twenties and his grandfather gave him his life savings to pay for the lifesaving treatment. Time and time again I hear stories like this.
Now the NHS doctors may not have the plush offices that I see here and may not be able to organise the same day tests and next day ultrasounds in fancy interior designed centres where you get free coffee and cookies but I would give all of that up in a second to have a system that was fair and available to all.
Eleven years ago I was ill, really ill. So ill that I couldn’t go back to work for five years. The NHS saved my life, gave me exemplary care and gave me the sustained treatment I needed to completely regain my health. The generous sickness benefits that the government paid me meant that, whilst ill, I was able to live with some dignity intact. I know that had I lived in the US at that time I would have ended up homeless and destitute and, probably, dead.
The system of social care in the UK protected me and allowed me to recover and go on to have a successful career in academia and museums. I will be forever grateful for this and I get angry when British people unthinkingly belittle the NHS because it doesn’t attend to their every whim.
The NHS is not perfect (certainly the dentistry side of things needs some serious reform) but it is undoubtedly the best system I know of. I hope that the current American administration will have the moral courage to enact their reforms and prove that America can be the compassionate society that I know it has the potential to be.
I just wanted to say, you write with such fluency and honesty that you have forced me to look at my own experiences of the NHS – those I experiences I moan about in the pub – in a new light. It’s strangely liberating to say, “Yes, I did wait, yes, I didn’t like the diagnosis, yes, the doctor was short with me… but I didn’t pay a penny for the service I received, and I need to be a lot more thankful than I am.”
Are you hearing that America? The NHS may not be perfect, in fact it’s a long way from perfect, but it’s our NHS, and on this day I couldn’t be more proud of it.
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What an extremely well written, and thought out post. I believe that any person who decides only to hear on side of the story is doing themselves an incredible disservice, but to be honest, they do say that ignorance is bliss! Universal healthcare is not an issue of political loyalties, it is an issue on which would benefit society as a whole. x
I am a Brit who has lived in many countries. I love the NHS, flawed though it is. I am employed by it and it has really dicked me around with pay – underpaid for 4 years, Grrrr! – waiting ages trying to get a special op for my son, and stuff like that, BUT if I lived in the US, I think I would probably have had a nervous and financial breakdown after his birth with all the medical care that he required/s. 18 months in hospital, 6 of those in PICU. I think we would have reached the cap on any medical insurance policy I could have got. The surgery he needs isn’t available here, so the NHS is organising (very slowly) and paying for a team to come over from the hospital where they pioneered the operation in America (don’t get too smug Republicans, there are some ops that were pioneered here too, e.g. heart transplants), to do the surgery in a UK hospital.
I am a physiotherapist – in my area you don’t need a referral for physiotherapy, you can just come to one of our Drop In Clinics. As a professional I love having the degree of autonomy that gives me.
I agree that the NHS can be very slow for certain things. I agree that availability of some treatments is very regional. The NHS is still the best healthcare system I’ve experienced even though I’ve had full cover private healthcare in countries around the world. I would be devastated if the UK ever decided to do away with it. Up in arms? I should coco!
It’s nice to know, in an emergency, when you need emergency treament most urgently, such as if you were involved in a road traffic accident, that the NHS will give you the treatment you need to save your life, whoever you are, whatever the circumstances, without any delay while they check your insurance details. You can still have private medical insurance but you’ll know that if you came in unconcious and in no state to prove insurance cover, you will still receive the best treatment the NHS has to offer regardless of you insurance cover.
I’ve heard stories of a tourist from the UK being involved in a road traffic accident in the US and not being fully aware of how the US system works, had left his travel insurance documents in his hotel. Once reaching hospital, he could not prove he had cover and so had minimal treatment under what I think is called “Medicare” or something like that in the US. He later in the week developed severe septicemia and had to return to that hospital, this time with his insurance documents, to receive a strong cocktail of IV anti-biotics to save his life. So if you are, for any reason at all, unable to even temporarily prove insurance cover, then you might only have Medicare which could be equivalent to early 20th century healthcare where drugs such as anti-biotics aren’t available. Of course this may be just 1 hospital’s interpretation of what is covered under Medicare and this is just one person’s experience on one occasion. I don’t know very much about the US healthcare system myself as I’ve never needed it on the few trips I’ve made to the US. What I have learnt is to always carry your travel insurance policy details on your person at all times in the US.
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[...] with the NHS and have no complaints – if you’re looking for anecdotal comparisons, I recommend reading this moving account by someone who’s experienced [...]
I stumbled across this debate and wanted to contribute; I haven’t had experience of the US system but have lived in the UK and Australia. In Australia I had private medical insurance for ‘in patient’ stays at hospital (paid for by my employer); in the UK I don’t bother with private health insurance because the NHS takes care of my needs.
In any debate of this kind it is inevitable that there will be a lot of anecdotes so I will add some of my own.
My own experience of the NHS would lead me to say that I infinitely prefer the NHS to the way healthcare is run in the US (from what I understand of the US model).
In the early 1980s my mother was diagnosed with myeloid leukaemia. Nearly thirty years later (at the age of 78) she is still very much with us due to the care she received at the excellent Royal Marsden Hospital, a specialist cancer hospital here in London. I do not believe that she would still be alive had we lived in the US; all her treatment has been on the NHS and she has not paid an additional penny for it other than what she contributed in tax through her working life (I can tell you that she does not begrudge the tax she has paid!).
I haven’t had nearly as much contact with the NHS, the odd broken bone but nothing requiring a hospital stay, occasionally I have attended the well man clinic (yes my experience is that the NHS does do preventative healthcare!) at my local surgery and am thankfully in good health. I did have one bad experience with a doctor – who diagnosed me with something I didn’t have! – and I simply changed doctors, easy as anything….so if there are claims being made in the US that there is no choice of doctor in the NHS they are simply not true – granted in some areas there may be waiting lists, but that is a different thing to what I understand is being alleged by Republicans that there is generally no free choice of GP.
If ever I want to go and see my doctor, I have always been able to get a ’same day’ appointment; the local GP has a system where you go in early and wait for an available time and I have never waited more than about 40 minutes for one of these appointments.
Sure the NHS does have its occasional faults – us Brits will complain about anything – but I’m glad it’s here and (from what I hear) would prefer it to the US system. It’s my impression – which I think is in the main backed up by other posts on here – that my fellow Brits agree; certainly there does not seem to be much support for a move to a more US-like model.
Thank you for an excellent comparison of the systems. Reading it helps me step down from the hyperventilating I’ve been doing re: the US propoganda. I’m an American expat living in Finland. We don’t have as deluxe care as NHS (there are co-pays and prescriptions are expensive…) but it’s darn good and I prefer it over the U.S. mess I experienced.
@Ian Diment Your friend probably was being offered medicaid, which is a bandaid payment program to cover emergencies for the uninsured, but hospitals don’t like to take its patients because of the low capped fees.
Medicare is a single payer health plan offered by the government to retirees (available to every US citizen at 65), permanently disabled and in some cases children (IIRC). It is not early 20th century care but in fact EXCELLENT care – the closest the US has come to socialized medicine, and ironically the most efficient in the u.s. in terms of standard of care delivered in proportion to expense margin.
Seniors with medicare can go to any doctor they wish and don’t need a referal for a specialist. My mother had agressive brain cancer last year. She was able to get second opinions, had multiple surgeries, all in a very short time window, without paperwork to ourselves. Medicare automatically approved each bill, and informed us of what we had to pay over their agreed fees. (they set specific rates for services, doctors in US can bill the extra from their list fee less medicare payment, but many simply cut their rate to the medicare fee.)
Unlike all my experiences with US medical treatment (fee-for service plans, hmo & ppo) we had no approval obstacles. No delays. No fights. No lengthy paper trails of submission forms to manage. She got the care she needed. In fact, her attending oncologist said that they prefer medicare because, unlike all the private insurers – 1.) they don’t employ bureacrats to waste the doctors time second guessing the diagnosis 2.) they have less paperwork 3.) they pay on time w/o the multiple cycles of charge disputes. Net result, doctor focus on the care.
It is neocon propoganda to be always putting Medicare down. It is, like all socialized systems, facing an impending budget shortfall with the aging of the boomers. And there is abuse – particularly in the rest home market – we did encounter some terrible examples of poorly run homes which existed to simply milk the medicare premiums off unprotectetd seniors. But they are an example of capitalism gone amuck under insufficient government intervention not “scary” obamacare!
But the real crime is that everyone in the US doesn’t have access to this care.
[...] This American’s Experience of Britain’s Healthcare System As the healthcare debate picks up pace, I find myself being asked with increasing regularity what I think of [...] [...]
I live in the UK and so have used the NHS all my life. What I find utterly shocking in reading this article is that so many completely basic features of the NHS are missing from the American system and that a supposedly advanced nation doesn’t have them. Of course health care is a human right. Can it really be true that in a modern country
• the health care you receive depends on what you can pay
• available treatments are limited by insurance companies(!!!)
• there are prescribed limits on how many times you can see your doctor (surely how many times you need to see them depends on your illness?!)
• there are 45 million people who aren’t adequately covered for treatment
• when you change jobs or move house you have to worry about how to afford your health care
• if you need expensive treatment you risk going into debt?
It beggars belief. And what I really can’t get my head round is why do Americans tolerate such an appalling situation?
So yes, you’re right that we’re horrified by the American system. Putting it bluntly, it looks primitive, unjust and inhuman, and seems to treat money as more important than human life… and yet people want to keep it as it is. I can’t comprehend that.
And I heard recently from someone that your choice of doctors depends on your insurance company, too—please tell me I’ve misunderstood that one.
Thank you for this article. I too am American and have literally just moved to the US (this past Saturday!) after 20 years in the UK with my British husband.
In June, my husband had a torn retina fixed on the NHS within the space of about 6 hours from walking in to the emergency room. Today, I’m still trying to get my health insurance set up; our application seems to have fallen between the cracks of the insurance company’s ‘System’ and I can’t get the agent on the phone nor does she ring me back.
I’ve been astounded by the wild exaggerations I’ve heard about the NHS since arriving back in the States; people here don’t know what they are talking about.
By the way, Americans currently spend more of their GDP on healthcare than Brits and the quality of healthcare in Britian is ranked higher than in the US. The US system is not second to none; only for those with gold-standard insurance.
At last a balanced and honest look at the two systems. EVERYONE LINK this page. America needs to know the TRUTH.
Excellent article. If I could just nit-pick a little – people talk about “the NHS” but there are actually four NHS’s, the Department of Health in London is only responsible for the English NHS, while the Scottish Government, Welsh Assembly Government, and Northern Ireland Executive can set different priorities for their NHS’s, which is why as an adult you will pay £7.20 for a prescription in England, and nothing for one in Wales.
Apart from minor sniffles, dentistry, and opthalmology, I managed to avoid having any major involvement with the (English) NHS until I was 44, when I slipped on the stairs at home, landed awkwardly and broke both my tibia and fibula just above the ankle. I dialled 999, a paramedic arrived within 10 minutes and an ambulance arrived a few minutes later. I was in A&E within the hour (had to wait a while before they straightened the leg while they dealt with a heart attack case), and I was in theatre having a plate and pins inserted within five hours of my fall. I spent a week in hospital, six weeks with my leg in plaster, and a further three months or so with once or twice weekly physiotherapy sessions. All at no cost at the time, of course, which was just as well as I was unemployed.
My mother on the other hand, really made use of the NHS. I understand she had serious kidney problems involving quite a time in hospital in the 1950s, and she completed the decade by having me by caesarian. As a farm housewife she never had paid employment, so never in her life actually paid a penny in National Insurance in her own right – she was covered by my father’s contributions. She also had two hip replacements in the late 1970s. Just before Christmas 2002, at age 81, she was rushed to hospital and diagnosed with two leaking heart valves. She was given a choice of either having surgery, with a 3 or 4% chance of dying on the table and (which is what put her off) a somewhat higher chance of suffering a stroke, or else controlling her condition with drugs on the understanding that a time would come when they just wouldn’t work any more. I think she rather surprised her doctors by looking after herself very carefully, together with receiving a weekly visit at home from the district nurse, and visits from her GP whenever she needed them, and managing to continue to live at home for over four years. For most of this time she was getting through a large cylinder of oxygen most days, provided free by the (Welsh) NHS, though we did have to collect and return the cylinders from our local branch of Boots the Chemists ourselves; in 2005 the Welsh NHS changed its oxygen provision mechanism and provided her with an oxygen generator and paid the electricity bill needed to run it. Finally in March 2007 she went into the local community hospital for a respite stay, but just before she was due to return home her condition deteriorated, and in the middle of April we were told that there was nothing more that could be done for her condition. Even so, she was a tough old bird, and she remained in hospital until early June, when she was transferred to a nursing home (again at NHS expense) for her last five weeks.
I’m incredibly grateful for the NHS and shudder to think how much the family would have had to pay for all this in certain other countries.
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thanks for this info and for sharing your thoughts!
i worked for a bit in the UK and had a NHS number/card issued to me. i wasn’t there long enough to actually use it, but i was amazed that i was automatically enrolled, even as a foreigner on a working holiday visa.
people who don’t want others to have health coverage just because it’s “socialist” are horrible. everyone should have the right for coverage.
btw, i don’t have health coverage right now because i am self-employed. i love what i do but i am only making enough to pay my bills. health insurance is a luxury for me right now.
[...] Continue reading here: This American’s Experience of Britain’s Healthcare System « Potential and Expectations [...]
[...] I simply refer the reader to some of the outraged responses to this debate: from the Times, Independent and just one blog. [...]
[...] http://potentialandexpectations.wordpress.com/2009/08/13/this-americans-experience-of-britains-healt... [...]
[...] There have also been some extensive personal contributions to the debate, some of the most interesting have been from Americans with experiences of both systems. For example, an American now living in the UK responded to a circulated e-mail from a family friend describing her experience as an emergency admission whilst on holiday, and here an American who had married a Brit but recently moved back to the US compares the systems, and …. [...]
Strawberry….
Thanks for this piece. I’m not going to tell all of my story it is far too long. As an American settled immigrant (married to a Brit) in the UK these past 40 years I have a great appreciation for the NHS. My son put me on to your page. He too has much to appreciate. You have put the message so well.
Maybe, I have been too long away from the US to understand some of the attitudes we are seeing and hearing. My one great hope when Obama was elected was that he would be able to help create a medical system that would work for those who can’t pay or who can’t pay for enough insurance to cover their health care needs.
Through our taxes we DO pay for the NHS but I have received so much back: care from GP’s, specialists when it was discovered that I had a hereditary kidney disease (after I had our 4 children!), eventually dialysis, a transplant and the drugs that have kept me going over the past 16 years.
Now my son has had a transplant. He is putting time and energy back into the system through his voluntary work in the NHS. I am working in the NHS to improve support for patients who have long term conditions. This helps them to take control of there lives and symptoms allowing them to be less dependent on professionals.
No system is perfect and the NHS will continue to evolve. I have seen many changes over the years. We all have to work to make it better. We can’t abuse it as often happens because we don’t understand that everything has a cost – from missed appointments, unused prescriptions, not taking responsibility for ourselves and it goes on. Of course there is unnecessary bureaucracy — get rid of it. But that will be no surprise to Americans!
We do have a responsibility to others and through our NHS we insure that care is given when it is needed. How can the US people continue to live with a system that does not care for those most in need? The wit and wisdom must be there to sort this out. Let us hope that the self interest of those that are running the system now does not stop necessary change.
Thanks again. I’m linking your blog to American friends and relations.
Avis
Hi. Thank you for the original post, and the same to all the commenters who follow. I’m late to the party and just about everything I could have said has been said many times already.
I’m UK born lived most of my life in England, married US citizen when both in senior years, and moved to the USA.
I’m now a US citizen.
While I’m covered by Medicare under my husband’s entitlement, we both have to pay a hefty supplement every month in order to keep ourselves covered for all (or most) eventualities. We also pay a lot of $$$ for regular maintenance medications.
I haven’t found care in the US to be any better than in the UK, and in the UK I’d now have free medications and no supplement to pay for all-round health care.
I had no criticism of the NHS at all. The treatments given to my parents, grandparents and other relatives were excellent – lacking nothing. I was rushed into hospital for a major operation in days when it was deemed necessary, remained there for 6 days with 8 weeks off work fully paid.
I doubt the same would happen in the USA unless one had a VERY good insurance and employer.
Whereas my American husband, before I met him, had given up working to care for his ailing mother who suffered from Parkinson’s Disease. He was not old enough for Medicare at the time and no insurance company would cover him because of his age. He fell down a”crack” in the system, and then unfortunately found himself in urgent need of having a stent fixed in an artery, cost $30,000. He was forced to re-mortgage his house to pay the bill.
I know of another US citizen who lost an eye and a kidney due to cancer, insuance didn’t fully cover him and he had to sell his home and land and finished up having to live in a rented trailer.
The differences between the two systems are so ridiculously clear, that only ignorance (wilful or otherwise) can be to blame for the misunderstandings currently surfacing.
My apologies to some of you whose comments were delayed in being approved — I’ve just discovered that a whole bunch of valid comments were put into my spam folder by Askinet and I have approved them now.
I need to figure out how to set it up that the comments on this one blog post don’t need approval. I like to approve the comments on my other posts (mostly, just so I see and read them all), but the comments on this post have been coming so hard and fast that I can hardly keep up with them!
I have to say, though, that I am so impressed and delighted with the overall tone of the discussion going on here. This is such an emotive topic and I’ve seen so many places where it’s got out of hand and ugly. I am deeply heartened that you all have left comments that have remained, for the most part, respectful and constructive, despite differing opinions. Wonderful to read!
I know most of you will have come to this post through a direct link, so I just wanted to draw your attention to my latest post, as it is relevant to the healthcare issue:
And Our Insurance Premiums Rise by 350%
http://potentialandexpectations.wordpress.com/2009/08/14/and-our-insurance-premiums-rise-by-350/
Strawberry: thank heavens for a bit of sense at last. The UK National Health Service has faults of course but in general it is excellent and invaluable. I live in a remote country area but I can get a doctor’s appointment at my local surgery (5 miles)on the same day; a specialist consultant appointment within 10 days to two weeks if needed and test results within 3 days if the doctor can’t do them on the spot. I have called at the local hospital (also 5 miles) on numerous occasions to be sewn up or otherwise repaired. My wife has Alzheimer’s disease and the psychiatric clinic have been superb and very supportive. Unfortunately not even the NHS could help my younger son who died of leukaemia but by the Gods they did their utmost and more. As for me, the NHS has certainly saved my life on two occasions (pneumonia and septicaemia) – and all this at no direct cost to me. Being now (well) over 60 I don’t even have to pay for my medication! And perhaps I should add that the local doctors, and here I mean the female ones who seem to be in the majority, are without exception gorgeous!
John Vickery UK
I’ve only had brief experience of US healthcare, but as a Brit I was in one sense impressed by the quality of service, but also completely shocked by the cost ($1000 just for a fractured wrist! Thankfully travel insurance covered it).
I felt the system is as much horrific as the right wing in America judge the NHS.
The NHS may be judged to decide on treatment based on cost effectiveness for the whole, but front line first thing the US system does is check your wallet before you’re allowed anywhere near a doctor, and if you can’t afford it (no insurance), you’re stuffed. With the NHS there’s always a guarantee you’ll get treated, no matter who you are and you can be assured you are not going to get a bill.
I also have concerns about the treatment I got in the US. It seemed great quality at first glance, and I got x-rays, told I had a fracture and given a fancy cast. However I got back to Britain and the GP couldn’t see the fracture on the x-ray. Nor could I! I do wonder if the treatment was actually required at all, and in fact all I had was a simple sprain.
The NHS big flaw is with the delays. Coming back home I couldn’t get my cast take off for a month after it should have been, and spent 4 hours in the waiting room at the hospital (costing a fortune in car park costs). Then again, if it was really a sprain I wouldn’t have had the cast in the first place. Hmm.
As mentioned, we Brits also have the option of private health care to supplement the NHS care. Surprisingly not many people bother with it even if they can afford it.
[...] pig/Tory. Update 1: Whilst on the topic of the NHS, I am indebted to captainjako for the link to This American’s Experience of Britain’s Healthcare System. It is rather good. leave a comment « British Neo-Fascists’ [...]
“We should judge our society on how we treat our most unfortunate, this is where the NHS wins all the gold stars.”
This is just one of the responses to your excellent post. Yes. How DO we treat our most unfortunate? The US is failing miserably at caring for our most unfortunate, and for that I’m ashamed.
I watched my mother slowly die from a horrible disease for which treatment was unavailable to all but the “elite” — until it was too late to be effective. (By the time her medicare covered the treatment, she was too ill for it to do anything but make her sicker and it had to be stopped.) What really gets me is that a celebrity received the very same treatment five years previous–but since my mom had no insurance, it just simply was NOT an option at a time when it might have helped her.
I cannot understand why we have so many who claim to be Christian, God fearing people, yet are wildly fighting against doing something to help those who need help. Even worse, they’re working to scare people about demanding a right to live…to be able to receive treatment regardless of insurance coverage. Would this not fall under a “pro-life” category? Or does our right to live end at the time we take our first breath — unless we have the means to prove ourselves “worthy”?
My daughter lives in the UK with her British husband and has been cared for by the NHS for 3 years. When they come to visit, if they have a medical emergency (and they have) it will (and has) cost them thousands of dollars to visit our hospital. Her care in the UK has been provided–and she also has the option to carry private insurance.
The US can do better. Yes we can.
Thank you for writing this entry–I’ve linked to it and hope that some of my conservative contacts will take the time to read it.
Prescriptions are free in Wales.
Really well written and balanced. Thank you! There is one thing that people to fail to fold in to this debate – and the reason why the US will have to change in the end. That is the role the US healthcare system played in the credit crunch. If you, or a loved one, were seriously ill (and you had reached the stage of losing both job and medical insurance as a result) and faced with the choice, of course you would re-mortgage your house to pay for the medical fees (a so “NINJA” loan). It guaranteed the mountain of bad debt would escalate.
I too have lived in both systems – with a NASA healthcare package in the US. What I hated in the US system was things like the endless paperwork over minor claims, the huge car insurance bill to cover putting even a small number of folk into hospital in an accident (and having to balance that number against spiralling premiums) and the thought it would be taken away if I became to ill to work.
For all its MANY faults (but they do not include the truly ludicrous scare stories now circulating in the US), the NHS means that the UK does not witness the obscenity of thousands queueing for volunteer-run field hospitals and even more people with no hope of any treatment. Yes we do believe health care is a human right and that to think it is OK to deny it to so many people is the antithesis of Christian values.
I am a British woman married to an American. My experience of American healthcare is limited to emergencies that have happened on holiday – including a tremendously traumatic appendectomy my husband needed. Our experience has been, on balance, that the US healthcare has not been very good compared to the NHS, but I don’t think that matters. That was just our experience, it could just as easily have been good if we’d gone to a different hospital for treatment.
What does matter is this: on one occasion my husband, a heart patient, had chest pains and because we were on holiday and covered by travel insurance, we went to the hospital. (By the way, if we were on holiday in another EU country, we wouldn’t even need travel insurance!)
They did exactly the same tests that our own NHS hospital does, kept him in for observation overnight exactly as our hospital would. Everything was just the same, except the insurance company had to pay for it. If we had had to pay ourselves, maybe we wouldn’t have gone to the hospital.
I can’t understand how a civilised society can have a system where you might not go to the doctor when you’re ill because you’re worried about paying for it. I just can’t get my head around it at all. Of course we pay for it on our taxes, but we also pay in our taxes for having the rubbish removed and street lighting and motorways – surely nobody would think you should pay for that kind of thing yourself? Why is healthcare different?
[...] have the vision to copy to every member of their legislature and every State Governor a copy of the blog by Strawberry (which has clearly gone viral) and the comments that follow it? It tells its own [...]
Strawberry – thank you for this post; it’s marvelous! I’m going to pass it on, link to it, tweet it…you get the picture.
To JJ – so sorry to hear about what happened to your mother! It’s a damn crying shame good old American greed has kept us from reform for so long, and that so many have died because of it. I agree with you about the “Christians” btw.
I’m one of the Americans who’s lucky enough to have decent employer-provided health insurance; it’s an HMO. Fairly reasonable premiums, great care providers, copays aren’t too bad. I recently had a tubal ligation, which was covered regardless of medical necessity, and my total out of pocket copays were $130. My portion of the premium, which I pay pre-tax, comes to about $100 a month.
Of course, to put the costs in perspective, 3-4 years ago my father retired. Some of the quotes he got for private insurance (for my stepmom and him) were in the neighborhood of $1600 a month!! I’m not sure what they’re paying now, but I’m sure it’s outrageous.
I want to say that those right-wing Republican windbags don’t speak for everyone here. Many of us know our system needs reform, and many of us are letting our legislators know where we stand.
I want the voices for reform to drown the windbags out. Reform needs to go viral. If their voices can be loud, ours can be ubiquitous.
Sorry to return yet again, but I just want to say this. A fortnight ago, I only had a vague understanding of the American system. I didn’t know that people could be bankrupted by health care or have to remortgage their house. I didn’t know people committed suicide over debt caused by medical bills. I didn’t know you have to pay a fee even to see a doctor at all. I didn’t know people with life-threatening conditions could be refused treatment.
Hearing about the American system has been a huge culture shock. Now, if one lf my American friends is ill, I worry for them, especially the ones who can’t afford health insurance. Previously, I mentally trusted their doctor to sort them out if it was something treatable—as I would for someone who lived here. Now I find myself wanting to campaign, not just to defend the NHS but so fellow human beings in the US can have proper health care.
I hope you DO get a proper system, as soon as possible. If you were some impoverished African country I could understand the situation, but you’re supposed to be a developed country . . . Please, PLEASE get yourselves a system where medical treatment is based on medical need and on nothing else. If people need treatment they should get it. It’s as simple as that.
@trendkiller7x
They may not speak for all, though it appears they speak for the majority. Combine that with they are the ones speaking the most and loudest, and a negative out come for the masses seems inevitable. The reformers need to show their numbers it seems !
To add to the origional post, the BBC citing some stats on costs and effects for 4 systems in the world (inc. UK & USA).
http://news.bbc.co.uk/2/hi/health/8201711.stm
Greetings from New Zealand
Like the British we have universal health care paid from general taxation for illness.
A separate system but still universal for injuries from accidents.
The US system is an absolute disgrace for a so called first world country, they have the advantages of a large population( 300M
versus 4M for NZ) yet on all counts their health outcomes are worse than ours, for which there is no excuse.
I feel pity for small businessmen who are based in the US, like me my American cousin employs around twenty staff, yet an enormous amount of staff time is spent in his business dealing with insurance companies who boast about their coverage until a claim is put in.
May I say well done with your blog post and in some ways looking from the outside maybe President Obama should have said, Medicare for all , regardless of age.
Join new Facebook Group “I’m Proud of the NHS”
I am an American citizen who was living for many years in Dublin, Ireland, which has a health care system similar to UK. I broke two ribs while living there and needed to be seen by a doctor at the local hospital for X-Rays and possible treatment. Since I was not an Irish citizen and not covered by the NHS I was required to pay, but only the equivalent at the time of approximately $75. This not only covered X-Rays, being seen by the emergency room doctor, pain medication, but also all follow-up visits having to do with my ribs. If I had to return twice or twenty times it would have all been covered by the same $75. In the USA, if an uninsured foreign national were to be seen they would most likely be sent to a public hospital for non-emergency injuries and not seen at the closest most convenient facility as I was, and be required to pay for all treatments in full. I would estimate my visit in the US would have been in excess of $3000 with bills arriving for months from individuals and departments that I had never heard of or seen during my brief stay. Please let cooler minds prevail in the health care debate.
I wonder if sending all the americans around the developed world (who are experiencing the benefits of an inclusive system) home for a while would help; so they could talk about what the real world is like to the masses of ignoramus’ …….
Please let cooler minds prevail in the health care debate.
Looks like Bush election fraud time, the media is already calling Obama as failing and capitulating on the government option at the moment.
Believe me, it doesn’t work. My wife, who is a U.S. citizen and lived in the U.K. with me for 8 years, tries to enlighten people all the time. People either don’t believe her or shout her down.
We live in a town of 80,000. It’s a 3 hour drive each way to anywhere larger. Over 50% of the employers here offer no health insurance at all. My last job here, before I gave up and started my own business, paid me $13 an hour with no benefits at all. I’m a computer network engineer with over 20 years experience. My last job in the UK paid £65,000 p.a.
With that job I was paying $750 a month for insurance for myself and my wife.
Now I have my own business but not for much longer. Having a conscience, I feel that I owe my (few) employees health insurance. With theirs and my own, I see $9,000 a month go out the door before earning a penny. Add payroll taxes and it’s just not worth it. We’re closing up, selling up and heading back to the UK.
Our health insurance, for the small fortune it costs us, tends to not cover very much at all. Here’s one small example. One Friday evening, I started to get a terrible pain in my lower back. I knew exactly what it was – a kidney stone. Anyone who has had one will know it is incredibly painful and not something you can just put up with.
The only place in town on a Friday evening open for treatment is the E.R. at the local hospital . As soon as my wife gave them the insurance card, you could see the $ signs light up in their eyes. A load of unnecessary scans and tests later, we walk out with a diagnoses (kidney stone) and some extra strength pain pills.
The next week, two things turn up. A denial letter from the insurance company – they felt I should have waited until Monday to see my regular doctor, and a bill from the hospital for $4,200. I’m still paying the thing off 8 months later.
As others have said, no system is perfect, but the U.S. one is so broken, it isn’t even funny. Unfortunately, they seem to have the ultimate in the “I’m OK Jack” attitude here. People who I would count as friends, quite honestly believe that if someone can’t afford health care then they don”t deserve it. I find that attitude abhorrent and indefensible.
I’m a diabetic, have vision issues, occasional chest pains and a gall bladder problem. Even though I’m covered by insurance, I will not go and see anyone here about these issues. The chances are the insurance company will find a way to weasel out of paying.
A couple of years ago, my wife needed surgery. Despite pre-approval letters, we still ended up with thousands of dollars worth of bills. She was literally spending 6 to 7 hours a day on the ‘phone between the insurance company, doctors offices, the hospital, etc. getting things straightened out.
I do work at medical facilities where out of 30 employees, 8 will be employed to deal with billing and insurance. What a waste of resources.
So it’s back to the U.K. for us. We’re getting no younger and the constant worry over health is just not worth it. I firmly believe that health care is a right, not a privilege. I no longer want to live and pay taxes in a country that believes that isn’t so.
Believe me, it doesn’t work ……… People either don’t believe her or shout her down.
Oh I do believe you, I’ve had the miss fortune of experiencing much the same every time I’ve been to the US (being a Brit on temporary placement in Canada) or met (the vast majority, though not all) people from there. The will-full ignorance is mind boggling.
Hence why I don’t go there any more, they seem to be getting as a mass what they want/deserve. Though as we can see from this blog it’s the ones that actually can see what is going on that are getting messed over.
My concern now is for places like the UK, Canada etc and the US health tourists/immigrants that are just going to turn up and load the systems.
As for “I’m OK Jack” …….. that really is the americon dream though; get rich and F everyone else. If you scale that up it’s much the way and attitude the country has to the rest of the world.
Lets hope it stays contained …….
Lets not foget our NHS is paid for by our National Insurance contributions, this is around 11% of earnings over £4500 per year, I think there is a maximum you will pay.
So if you earn £20,000 a year ($32,000) you will pay around £1400 ($2240) per year. But don’t foget, that also pays for your old age state pension of around £100 per week, which all who have worked for long enough will get from the age of 65.
Hearing about the American healthcare system is a real eye opener. How can a economic world super power treat it’s people this way.
I also have private health insurance here in the UK (£40 per month, I guess the strength of the NHS keeps the cost of private down) but I only have that as I run my own business and would need very quick treatment. Though the NUS has improved so much in the last 5 years I don’t really need insurance. I recently got an appointment with an NHS Nuerologist within 2 weeks.
Fabulous piece—thank you for an honest and well written post comparing the two systems. I always felt it was better to hear from people who have experienced both than rely on the politically driven drivel that I see emanating from some folks. To the above commenters, thank you, too, for your stories—I’ve referred this post on my blog and hopefully it will open others’ eyes about the pros and cons of the respective systems.
A link back to here should be sent to all the 790,000 supporters on Sarah Palins facebook page.
Like most people this slating by the certain elements of the US media and politicians has made me re evaluate how I look at the NHS. Along with many others we just accept it will always be around when we need it. But that will only be true as long as we defend it to the last, that’s probably why we feel we need to put the record straight .
Suppose the only problem with doing that is if Obama fails, any American with an ounce of sense will be on the first plane over
Decided to see how much US health care would cost my family (wife and 4 Children) Used a New York insurance web site….. and fell of my chair. The cheapest was $900 a month and average $1400…. My taxes are 35% and that covers all the usual national and local services including my unlimited NHS access.
Great post. Really measured and thoughtful and fair.
Paul
Join new Facebook Group “I’m Proud of the NHS”
I live in Italy where the health system is public paid by people taxes much like NHS, my family and I never had big problems but on the papers you only hear about bad things, we pay for some stuff and sometimes we choose private specialists but never in a million years I’d choose anything like the US system!
A couple of months ago I was in the UK as a tourist and had to visit the NHS Dental Centre in Edinburgh. I was worried out of my head for the pain, the people at the B&B I was staying predicted a long wait and probably high fees to pay.
I waited a very reasonable time, the nurses and dentists were kind and professional, taking their time to explain to me the procedure and offering me various options. For more than an hour of work, x-rays, medication, filling replacement and prescription for antibiotics I only paid 18£!!! I couldn’t believe my ears and had to ask again because I thought they said 80!
Here in Italy I doubt I’d ever get that kind of service, let alone for that price, and for an emergency.
Thanks NHS for not letting my vacation turn into a nightmare!
This has been a great discussion. NHS is a wonderful thing- because it emphasises the importance of everyone caring for everyone else. It would be very hard for the US to have it because essentially it seems that the people of the USA would prefer their available public funds to go to making war, and trying to fight off terrorists- a belief that Might will Win.
Focussing on the weak and sick is a completely different mindset. It is not prestigious, a matter of the left hand not knowing what the right hand is doing. In fact the NHS gets on with its job so quietly that the USA knows very little about it-hence the strange stories going around. such as the NHS is a hotbed for terrorism.
This discussion has been extremely useful for me because it has reminded me of the priorities- caring for the weak and sick. I hope we pull out of Afghanistan and re think where we are going ad a nation and STOP looking to the USA for leadership.
[...] 18, 2009 · Leave a Comment An important, clear, and honest interruption to the flow of misinformation about healthcare, and especially the differences between the US and [...]
[...] to do a comparison, firstly because this blog would turn into a book, secondly because blogger Strawberry, an American who spent 14 years in Great Britan, has done a really good job of doing prec… (excellent overview), and thirdly, because I haven’t yet told you the outcome of my three [...]
Immediately after college graduation, my two best friends and I spent a year working in England. Because we were working (we had work visas through BUNAC), we paid British taxes, which meant we received NHS cards.
Living in a basement bedsit with no central heating for the winter, I ended up getting several ear infections. When I got my first one, I panicked, having no idea what I was supposed to do and how I was supposed to find a doctor. BUNAC helped me make a call, and I was seen by a doctor three blocks from my house that very day. When I got my other ear infections, it was such a relief knowing that I need only make a call and I could be seen. However, when my friends got sick, they were so used to not going to see a doctor (which is what they did back in the US) that they didn’t even bother trying to make an appointment, despite the convenience of the system.
Without the NHS, I’m not sure what I would’ve done. I was working as a temporary secretary at the time, so I wouldn’t have been able to afford private insurance OR a doctor’s visit. I have always been thankful for being able to use the NHS. And while I’m sure it’s not a perfect system, no system is; but at least this system allows starving college (and post-college) kids the chance to see a doctor when needed, something the US system doesn’t.
Having “bumped ” in to this piece I must concour with it’s accuracy. Born, raised and educated in London I moved to the USA as a 22 year old I have had two knee surgeries in the US, sports injuries and have had excellent care. My insurance was through my employer, like most policies I was responsible for 20% of the bills about $10, 000 total. So even with “Great” insurance provide by a huge corperation I was out $10,000. Plus don’t forget I had paid premiums and co-pays all along. I had had two surgeries in the UK both covered by the NHS, great care, great follow up and no direct bill. Was the UK treatments free ? Of course not ! The bills were paid by my taxes and by the taxes of my fellow citizens, Now given a choice ’sign me up for the NHS ” ! Recently Remote Area Medical held a “free” clinic in Los Angeles, it made the USA look loke a third world country. How can the richest country the world has ever seen treat it’s citizens with such contempt ?
that someone say he had to wait 15 years for dental care i cannot believe unless he has other circumstances which were not written down.
dental care is easily available on the NHS and fast too.
http://www.nhsdirect.nhs.uk/
this link takes you too the main NHS site and from there you can choose what area of medicine you need
http://www.nhs.uk/servicedirectories/Pages/ServiceSearch.aspx
in that link you can put in your postcode and find NHS Dentists in your area
so i cant really see what his problem was.
I used this to find a local dentist in my area and was seen within 4 days there are also emergency dentists who will prescribe anti-biotics if you need them and these you can go to on the same day.
so with this evidence and my personal experience i cannot see why this person had to wait 15 years to see a dentist.
Grew up in Britain, been in America for
thirty years. Basically I feel that Americans have been brainwashed. They have been on the receiving end of a lifetime’s worth of
misinformation on this very expensive subject, from which many large American companies make so much money out of them.
I’ve had health treatments on both sides of the Atlantic and I found no real differences, except that in America my insurance company would only pay for a fraction of the cost and then dunned me for the rest!
I saw both my parents die under the NHS and both received extensive treatment.
Big difference was that my father died after the Conservatives had been in power for 17 years and had starved the NHS of resources, while my mother died midway through the Labour Party’s reinvigoration of the NHS. Her care was
undoubtedly better.
The scare stories tossed around in the US relate more to the NHS of the 1990s, than they do to the present day.
The biggest difference between the two systems?
There are no recission departments in the NHS. Nobody in Britain goes bankrupt because of NHS care.
Great post and really interesting comments being debated, all carried out in that great American tradition of open and honest debate – what a shame that has been let down by the misinformation and paranoia spread by the Republicans!
For the US citizens reading this and concerned about what it means for your individual wealth to pay a tax to support universal healthcare, it’s worth pointing out – and taking a minute to think about it – that EVERYONE working in the UK pays this tax, it’s deducted from your salary. So, with everyone in the same boat, and therefore with the cost of living adapted to take account of it, no one really regards it as a loss. I’ve been paying National insurance (as it’s known) all my working life and I honestly don’t think I could tell you how much it is, even though the deduction is listed on my monthly salary slip, it’s not even something that I consider. With all working people paying it as a percentage of their salary, there’s no sense of being worse off than anyone else for having to pay it.
There’s no doubt the NHS has had it’s challenges over the past couple of decades, but there’s been some key reasons for this:
1) the under-investment and undermining of the NHS by the Conservative government in the 80s and 90s
2)the balance of the population has changed with decreasing birth rates and people living longer, so that the working proportion of the population has gradually shrunk in relation to the post retirement proportion of the population. Therefore there are more people’s healthcare being supported by a lesser tax base.
3) a lot of the care that we now regard as ’standard’ such as MRI scans is very costly, and equipping the NHS with this expensive equipment is a greater challenge than was faced before such technology existed a couple of decades ago.
These issues have stretched the NHS in ways that the system was not originally designed to cope with, but like most UK citizens, I’d prefer to accept the imperfections of the NHS over private healthcare any day.
America – do the right thing!!
I think the bottom line here is really “Do we care about others who are sick whether they are rich or poor?”
As a Nation the UK decided in 1948 that the health of the Nation comes first and i cannot say how proud and grateful that makes me feel, as a Citizen of the United Kingdom, that my ancestors took this bold and difficult step.
Health and good health is a right. A human right.
I never really thought about this until the debate overspilled into England and the public outrage at some of the untruths that were being bandied around in the USA about the NHS in the UK came to the surface. I suppose the NHS was something that having had all my life I took for granted.
Having now spent sometime in thought on this I can honestly say that I would never ever in my life begrudge paying the 11% National Health Contribution taken from my wages even when i am not sick because i know it is helping someone who is sick and now [because i had not thought about it before] knowing that i contribute to someone else’s return to good health and treatment this makes me feel good about myself as i am sure it makes others feel who have a National Health System.
I know that someday a politician in America is not going to worry about being voted into office the next term and is going to have a political conscience and enough humanity to drag the whole of America into a National Health Scheme based upon clinical need for it’s own people. I hope that day comes soon, until then, i wish good health and long life to all Americans on both sides of the pond.
It’s just fantastic to see so much praise of the NHS from people in the US. We in Britain know the NHS is not perfect but we don’t want it to be given away to the private sector who then profit from illness. There’s surely something obscene about that!
Join new Facebook Group “I’m Proud of the NHS”
I don’t think it will ever come close to an action as politically suicidal as that.
Continuous improvement, as with any system is what will likely happen. Luckily most people doing that know that the idea of a “perfect” anything is laughable.
Not only does watching the US system literally kill its own people in the pursuit of profit reinforce that, the benefits of a caring society far out weight any negligible cost to the individual.
i thought it would be nice if i, for the American people reading this blog, were to place links in this post to the NHS; own website. [i have done so already but that was to show you about what the NHS offers you].
These links are about the NHS constitution which was published on 21st of January 2009
http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx
and the other link is to the patient “Rights” to choice.
http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Yourrightstochoice.aspx
I do hope this will help those confused Americans who have heard some horror stories about the NHS but were brave enough to seek answers for themselves find some more clarity
this link is about your choice of treatments
http://www.nhs.uk/choiceintheNHS/Treatments/Pages/Treatments.aspx
Perhaps taking the time to peruse the NHS website will show you a lot more about the system in the UK
it is true the NHS is not perfect but give it the right funding and time and i am sure we will make it better.
I am sure the majority of doctors in America are like the doctors in the UK they choose this profession because what drives them is the wish to heal and experience the immense satisfaction they get from seeing a person cured or without anymore pain leaving their care.
To be honest i cannot think of a more demanding yet most fulfilling job.
Thanks Hephaestion, for providing these links. It is obvious that majority of Americans need the education and the clarifications.
At my work place I have had to answer questions from patients, relatives and colleagues about- “The truth about the British Healthcare system”. Some say they have ‘heard’ that because healthcare is free you are on a waiting list till you die, some ‘heard’ that at certain age you are prevented from having heart surgery because the government controls this and a whole bunch of other nonsense.
Alot of people are ignorant, no doubt, they need the education, I can only hope that they will seek the truth and not allow themselves to be brainwashed by politicians!
Thank you for writing this, Strawberry. The post itself and many of the comments are a great insight into the comparison between the two systems (socialised healthcare and non-socialised).
As a chronically ill young Brit who has been living in poverty almost her whole life, I have a LOT to say on this one…
My father was employed in the building trade when I was a very young child, in the late 1980s. (He used to drink heavily outside work, which is relevant later.) My mother was diagnosed with non-Hodgkin’s lymphoma when I was almost three years old and my sister eleven months, and her doctors predicted anything between six months and six years of life depending on her treatment. She began to undergo chemotherapy and radiotherapy (I was too young to know which, and my father no longer remembers). Two years after her initial diagnosis, the firm for which my father worked “went bust”, as he always put it. He had begun having problems with joint swelling and pain by that time, and rapidly became a true alcoholic. Had we been reliant on his job for my mother’s healthcare, she would have died, but instead, she kept on with treatment, and was in remission twice for lengthy periods during my childhood. She survived fourteen years after initial diagnosis, which is to say she was present for the majority of my childhood and adolescence, up to the age of sixteen, because of the NHS. She ultimately died partly due to hospital negligence (she was taken out of isolation just a week post-allograft, and caught a chest infection her new immune system was unable to fight), but my sister and I got to know her and love her because the NHS allowed us to keep her that long. If we’d had no healthcare, due to our family’s lack of income and needing to be on welfare, it is highly likely, from all I know of the US system, that that would not have been the case.
When I was 14, I was diagnosed with Raynaud’s syndrome and migraines, separately, both necessitating a visit to a neurologist, which I am aware would have been at least $200 per visit in the US. For me it was free, as were the painkillers and preventative medication I was given thereafter, because I was under 19 (and in full-time education, though if you’re under 16 you get free treatment whether you’re in school or not). I was diagnosed with asthma the following year, and have had two inhalers on two doses per day ever since (I’m now 23). I had multiple doctor’s visits over that time for recurring sinusitis, issues stemming from hypermobility (then undiagnosed) and random other things like ear infections, all free treatment.
I was referred to a community psychiatric nurse for treatment for bulimia at the age of 16. This is where my local (until I was 20) Primary Care Trust failed on treatment. There is even an article here about the village in which I was born and grew up. I knew Nigel through my father, and Jess, the 17-year-old mentioned in the article, was a good friend of mine and niece of someone my father has known and been friends with since their childhood.
Psychiatric care in that area, unless you’re openly violent towards other people, is awful. One visit a month – or possibly every three months – for fifteen minutes each time. Is that enough to assess someone’s psychological state? I don’t think so. The first CPN I saw said she thought I had rapid-cycling bipolar disorder (which, it turns out, I do), and referred me to a specialist psychiatrist, who diagnosed me with chronic depression (which wasn’t the case then, and still isn’t. I was simply going through the worst depressive episode of my life immediately following the death of my mother). He prescribed me Seroxat – better known as Paxil in the US – and sent me home. I was on that medication for three days, and they were the most miserable days of my life because I couldn’t do anything. I couldn’t eat, sleep, drink, stay still or stop talking. My father compared it to seeing someone on a bad ketamine trip. I was suffering dehydration headaches by the end of the three days (it was over a weekend), and he took me straight to see my GP – and he wasn’t shy about his complaints either. Paxil is something not meant to be given to anyone under 16, and I was just barely that age. I spent three days coming down off the stuff, and it was awful. I was referred to a different psychiatrist, same hospital. She first prescribed me venlafaxine (Effexor), which made me so agitated that when I took a dose a few hours late and had a row with my father, I lost complete control and put him in the ER for stitches after throwing the contents of a full coffee mug at him and catching him on the ear with it. It didn’t help me. Edronax (reboxetine) was next, and that landed me with writer’s block that drove me crazy for 18 months. I could not write, and writing is a huge part of my life. As I recall, being on that medication made me simply numb. I went for a period of time after that with horrendous mood swings and physical consequences and very little treatment because I could not stand being treated without the person treating me paying even a little bit of attention to what I was trying to tell her, and it is harder there than in most areas to get a different specialist – that is the main psychiatric institute in the area.
I began suffering from menorrhagia and chronic dislocations of both shoulders after a fall downstairs when I was 17. I also suffered three concussions between the age of 15 and 21, all bad enough for X-rays and one severe enough to necessitate a CT scan. Despite a smear, my gynaecological nurse could not understand why I was bleeding so heavily. I underwent an MRI scan (had to wait nine months for it, the longest I have waited for a non-dental procedure yet) to see if they could figure out why my shoulders kept dislocating. My consultant said that they were simply loose, the left more than the right. I was referred to a surgeon for possible solutions. He explained that he could pin it, but that would limit my mobility and he would rather not do that, or that he could go in and tighten up the ligaments in my shoulder, which would leave me in a brace for a month and hopefully solve the problem with post-op physiotherapy, but it still might not work. All free. I chose the latter option, and spent four days in hospital in 2005 for the operation, which unfortunately was found to have failed after I came out of the brace.
A month after that, I slipped on some rounded-brick steps at my college on a rainy November night – slipped on the top step and landed hard on my back across the bottom one. I was stiff and sore, but managed to pick myself and my things up and make my way to the bus home. Three days later I was writhing and screaming in pain every time I tried to move from sitting to standing or vice versa. I could only take baby steps when standing because anything else made me start to cry with pain. My (then new) stepmother called an ambulance for me and they came within fifteen minutes (I was eight miles from the nearest hospital, and this was 10pm at night on a Sunday). She went with me in the ambulance to the hospital, where they put me in a wheelchair, took me for a spinal X-ray and finally diagnosed internal bruising. They gave me a large dose of Tramadol (which at that time I had never before been given) and a prescription to continue it for a few weeks, which worked so well at the time that I managed to walk the three miles downtown from the hospital with my stepmother at four-thirty in the morning (they don’t generally provide transport home, but will refund the costs if you apply). It took us two hours to walk that far, because she was at my pace. (Rural town – buses don’t run that late.) Granted, I fell asleep on the table in the coffee shop while waiting for it to be time for me to go to my psychology class at the college at 9:30, but I still made it.
Unfortunately, I haven’t been out of pain since. They couldn’t figure out why in that district. I moved to Somerset for six months, and was referred to a rheumatology clinic there due to my chronic joint pains, whose consultant then diagnosed me with hypermobility syndrome (not a big surprise in retrospect, as my father has hypermobility-type Ehlers-Danlos syndrome and these things tend to be hereditary). I wasn’t there long enough to get a psychiatric referral, despite the fact that when my new GP gave me prednisolone to ease the swelling I felt but she couldn’t see, in my knees, it made me hypomanic for the whole two weeks I was taking it. It just took so long that I was moving house again before they could really treat me.
In Manchester, they saw the chronic pain issues in my medical record and referred me to a pain management clinic, where I was diagnosed with “probable fibromyalgia”. That switched on a major light for me – my best friend has fibromyalgia and has had since before I met her, and I know from the research I did when she first mentioned it that spinal trauma is a major trigger factor for it, and that I do have almost every symptom available. I’m currently being moved from treatment to treatment, and walk with a cane these days (almost four years after the initial accident). But I know what is wrong, and I’m not on the street and bankrupted by my medical care as I would be in a country without socialised healthcare, as I am on disability welfare now due to my level of illness – and that’s a great comfort. An immense comfort. The NHS has been a safety net for me, despite the lousy care on the mental health side of things (I’m still having trouble with that). I was once asked to move to Florida by a girlfriend, and my healthcare was a major consideration in my decision to apologise to her and gently refuse.
In addition to which, I received free birth control during the years I was experimenting with my sexuality and still could if I wanted to, even though I am very sure now that I’m gay. I didn’t get judged for wanting birth control at 17 years old, nor for my homosexuality, and still am not. The only thing I’ve experienced noticeable discrimination over within the NHS system is my age – because I am young and my chronic illnesses are of the invisible kind, I have often been treated like a hypochondriac.
That said, I would not give up the NHS system for anything. It is the main reason I’m alive and relatively sane, after three suicide attempts in my teens and chronic illness that has often made me suicidal. I shudder to think of the position I would be in as an uninsured disabled woman unable to work and with no income, if I lived in the US. The medication I receive here comes to $24,000 in the US all by itself. I do not understand how people with means can look at that system and say without conscience, “well, it’s not me, so I don’t care.” Someday it could be you.
TL;DR: British, disabled but alive and holding by Nye Bevan’s quote, “No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
(Also, sorry for flooding you with all my comment replies, Strawberry!)
great post, but it still doesn’t answer the following questions which are unique to the american problems with health care reform:
1) why is the federal government so intent on collecting everyone’s medical data and making it electronic information?
2) why the rush?
thanks.
@phoenix mattress
“1) why is the federal government so intent on collecting everyone’s medical data and making it electronic information?”
Probably because it’s easier to access it across a range of services. So, if you’re taken ill 500 miles away from home, the hospital which treats you will be able to call it up and as a result give you better care.
“2) why the rush?”
Because people are dying due to lack of healthcare?
It is “capitalism”at it’s worst!
A government that mostly relies on donations from mega businesses — “money talk”!
Lobbyists ‘pursuade’ government members to vote in the best interests of those businesses, because of mostly uninformed voters.
The wealthy, for-profit health industry is excempt from “anti-trust” law; pharma. can’t have their prices regulated (except Veterans’ Administration) and the said businesses are subsidizedby tax payers in Medicare (Advantage/Part-D), the “socialized” health-care for over 65 yrs. old!
The Republicans are the ‘Christian’ party — “bearing false witness” against the N.H.S.! What about, “When you do it unto the least of them, you do it unto me” — people dying in A/E (Emergency), waiting for the ONLY ‘CARE’ for ordinary people, who can’t afford expensive ins.?
My son took my daughter to an “Urgent Care”(private clinic) in excruciating pain — with glandularfever — but was sent back to get her ins. card, before they’d see her!
I complained to the ins. co., once I found out, because I pay 50% of my wages for our health ins., as a self-employed person!
Not forgetting, how absolutely WICKED to let my child lay there (across several chairs!) waiting for her brother to return, with proof they could pay for her care!
I don’t get the tests the doctor wants me to get, because if I have an illness, the ins. will be TOTALLY UNAFFORDABLE!
Therefore, despite giving 1/2 of my wages to the greedy ins. co., I try to stay “under the radar” to protect everything I’ve worked for my entire life — disgraceful!
Thank you for your thoughtful posting. As a Canadian with British family I would like to add that somehow the “news” on Fox seems to rank our two countries as “socialist” health care! I have no complaints whatsoever about our Canadian healthcare system having received highly skilled, timely and caring healthcare when needed. Never do we receive bills for our services, never are we expected to wait when it is truly an emergency, never are we denied care no matter what our financial circumstances. My family in the UK say the same of their health care.
We also agree that we are all very happy that we live in countries that respect all of their population equally! When is America going to stop wasting their money on warfare and look after the health of Americans?
Strawberry, you are a gifted person! I want to thank you so much for putting time into such a precise and coherent write up.
I am dual national with one of my citizenships in UK. I have lived and worked as a nurse in the NHS and in the UK for 7 years. I am presently travelling and working as a nurse in the US for the last 9 months.
Since my arrival in the US, I have met a lot of disappointments in all aspects of public services and I was really shocked with the operations and structure of the healthcare system, (I am still wondering if I arrived in the right AMERICA!) I often experience feeling of fustration at work because of the way things have to be “done”….cases like individuals needing multidisciplinary dicharge involvement, will not get one, even when it is absolutely reguired just because the individual does not have “insurance” to cover home health services. Within my first 5 months in this hospital I had a major aguement with the Primary physician, case manager and the hospice assesor who were all involved in a discharge process that as the patient’s nurse I was not satisfied with. In the Uk, what transpired will NEVER happen!!!! This is just one of my many frustrations.
Luckily I work for an employer who have me covered on a good health insurance but I have not been able to bring my self to face the reguired paper work, the bureaucracies……. I simply dread the whole process. I am hoping and praying that I keep enjoying good health till the end of my contract and I can afford my self some peace of mind again with the services of the NHS.
A lot have been said by so many people, sharing experiences and supplying proven data to illustrate the fact that Socialised healthcare is more beneficial.If I’m asked to choose, I will at any time choose socialised medcine based on my working experience in two environments that illustrates socialised and non-socialised medcine. I must also say that I’m making this choice fully aware that there is no system that is 100% or perfect, I am simply making the practical choice.
I must say that all is not gloomy in America, I have enjoyed great friendship and kindness from people I work with and socialise with, but when it comes to serious issues that affect health, life and living I do not support the present health care structure in America.
I observed that due to selfishness of certain groups of people within the corridors of power, that are benefiting from the present structural defect, the birth of a new and better structure wiil be prevented. I therefore encourage eveyone reading these contributions, whether participating in the discussions or not, to make effort to give information to a lot of baised Americans out there who are meant to be beneficiaries of the socialised medcine but in themselves are working against its coming to existence because of lack of knowledge.
I am praying for President Obama’s goverment to be guided by God to do the rigth thing and achieve good health care system for everyone but especially for the less previledged of America.
I have a few stories to share. I’m 17, a Brit, and a huge supporter of the NHS.
Regarding bad GPs – yes, there are some. I’ve had about one in my lifetime that thinks I’ve been lying for attention.
It does depend on which practice you are with on what service you get. At my old place you had to wait a week, and then ages in the waiting room once you got there. Now at the new place down the road which actually has a car park, you may have to wait 1-4 days (longer since Swine Flu, and it depends on my timetable of when I can go in) and usually 2-10 minute s in the waiting room rather than half an hour! And they couldn’t be better. They want the best for you. I’ve never had to pay for anything aside from a jab I requested which was about £2, since I’m a student.
About dentistry- it took around a month to find one in my area, and that one is about a 20 minute drive. It’s a very good place, but there wasn’t anywhere else closer. Dentists make more money if they go private, and many of them have. My brother has moved back and can’t find anywhere. I don’t blame the NHS though.
I work for a clinical negligence claims company, typing up medical records. So I have heard hundreds and hundreds of BAD stories of the NHS mucking up. Only once, in a very upsetting story, did I feel that my high opinion of the NHS could be changed. Obviously I can’t go into details, but she was about my age and they managed to accidentally take out her ovaries, bladder, and lots of very important guts. Now she is in a wheelchair and has a bag on the outside of her body to carry her body’s urine. Now this contrasts with everyone I know using the NHS and having little to complain about, aside from waiting lists and time spent in A&E. Usually in these negligence claims I don’t believe the NHS is at fault, and they’re just trying to sue the NHS (which I hate, they don’t have money to spare really). For eg, there was this one claim I remember about someone that had a car crash and was blaming the NHS for not curing their depression, that apparently the hospital had caused. There was an entry something like, “recommended counselling, patient refused. Patient insisted on medication immediately and got hysterical”.
In comparison to America, my mum’s friend in America has ME or MS. I’m sorry, I get confused about the name, but it’s the muscle degenerative one? He has to lie about his health or else he won’t be employable, and they’re in serious money trouble paying for his medicine under his wife’s plan.
What a life Americans leave! It’s hard to believe people still live like this. It’s a bit primitive, putting money before health. No matter how rich or poor you are, you’re going to get medical treatment. If someone was sick they might be discouraged for days to make an appointment, under the pretense that it may just go away, and all the while it could be serious and getting worse.
If someone does have a real problem with the NHS, you can always go private. I would only consider that if I had to have an operation very quickly, and I was put on a long waiting list, and had the money.
Great article,
x
My sister was a nurse (Sister, actually) and wanted to work in the U.S., but I told her that she wouldn’t be able to stand it. Your story substantiates that, so thank-you for sharing it, Paula.
You mentioned praying for President Obama to succeed. Let’s keep on praying for God to protect and guide him, because I am so concerned for his safetly.
The President needs all the prayers he can get, with those characters flaunting guns at his meetings — astonishing!
Thank-you, too, for your kind words and for sharing your story, Kitchenerd (and Jane).
I hope the Republicans — who mostly want the President to fail, rather than Americans to get health-care — read these comments.
People are SUFFERING and DYING for lack of health-care, particularly TINY BABIES, because of little/no health-care for their mothers’ (29th. out of 30 industrialized countries in infant mortality!!!)!
God commands: “Thou shalt have no other God before me.” It appears as though money has become a ‘god’ …!
The difference as I see it boils down to expectations, which are much, much higher in U.S than in Britain or Canada. In U.S folks want to pay for a cheeseburger but demand a filet mignon with all the trimmings, now (no wait to cook), and if it is not done to their satisfaction they get to sue the cook. It doesn’t matter if they have a good reason to sue, the malpractice lawyer will file the case in an area where the juries tend to be sympathetic to the plaintiff. Even if the cook (doctor ) wins, he has spent untold amounts of money defending himself, taking time off work while covering his overhead, etc
I have no gripes with the quality of the health care available through the NHS. My gripe is with the redistribution of wealth. This is the basis of insurance — people who don’t need it pay for people who need it. In my opinion it is not the job of the government to pay health care, social security, or anything like that. I don’t know much about England, but the founders of this country intended that the government provide for the national defense and infrastructure for trade with other nations. Those are the only jobs of the federal government; everything else is up to the states. We should not federally fund art, or science, the federal government should not control corporations, nor banks, nor is the purpose to support anything not falling directly under the specific scope set out in the constitution. The federal government has grown in scope dramatically by pernicious blackmailing of states and usurpation of state sovereignty and rights. The health care plan that has been proposed will even further undermine the rights of the people; the bill is not a health care bill; it is an insurance company regulation and destruction plan. the two most lucrative industries in America are banking and insurance; the federal government is rapidly taking over both of these so as to further control the lives of the citizens and destroy free enterprise. The banking fiasco was caused by the government (I believe) intentionally. Now the same thing is happening with the insurance industry (Oh and the car industry as well). In Europe the health care system is the single largest employer? Pretty soon, in the USA the government will be the largest employer. Follow this to the conclusion: eventually we will all work for the government and be paid about the same while a very small elite group will control everything. No thank you.
[...] response to my blog post on the NHS was overwhelming, and I found it fascinating to read the comments as they came pouring in. [...]
Lack of regulation in banking brought the world to it’s knees!
The American health-ins. industry is exempt from “Anti-Trust” Law…?!
“A very elite group” DOES “control everything” in Americas’s for-profit, private health-care industry!
No thank-you!
Lack of regulation in banking did not bring the world to its knees. The central banks using fractional reserve lending and greed brought the world to its knees. It is the bankers who are profiting. To solve this problem simply eliminate the federal reserve. Indeed an elite group controls everything. And we elected them. 536 of them.
Came here via Ravelry and a bit of personal interest, and I loved the post and am enjoying the comments atm. I just wanted to point out that the NHS has had a few rounds of reforms, some extremely recently, and while I’m sorry for the people who had bad experiences with UK healthcare, I hope (and kinda expect) that the problems described as happening a long time ago (one commenter said 20 years!) would be sorted out by now. I certainly have a better time with the NHS now than say 10 years ago.
I don’t have experience with the US system but I personally, as a longtime student with three chronic conditions, am glad I am where I am. I buy a “season ticket” every year for about £100 and don’t have to pay anything for prescription drugs for the rest of the year. Chronic conditions are supposed to be treated for free, but I have so far been denied full free treatment for anything – maybe they are hoping my asthma will disappear after 27 years, I don’t know ><0
The main problem I have with the NHS is the waiting, and I can see that that is because of demand. I waited a matter of months for a CFS clinic (which was closed in a budget cut two months in anyway), and about six years for a psychiatrist. There just aren't enough people working in those posts to go around.
Dentistry looks to me like the biggest argument against semi-privatising the NHS. Getting into a NHS dentist's clinic can be a nightmare – again, there just aren't as many dentists as patients out there. I'm lucky in that I can easily drive home to see my childhood dentist twice a year and keep my membership up – if I'd moved much further away, I too would join one of the interminable waitlines.
Lack of regulation in banking brought the world to it’s knees and lack of regulation on America’s mega health-’care’ industry (ins. exempt from Anti-Trust Law!!!) is the ‘knee’ on ordinary Americans, keeping them down!
The “elite group” was voted out of office, but the damage was done, so President Obama — the President for common people — is working hard to correct that, by offering a Public Health Service for ordinary people!
1 CORINTHIANS10: 24 (NOONE SHOULD SEEK HIS OWN GOOD, BUT THE GOOD OF OTHERS.)
Why do you expect the government to provide for you? Should the government also feed and house you? If they do, where is the incentive to actually WORK ???
You seem to be missing the point quite profoundly, though likely intentionally to support your own opinion.
To take your argument to it’s conclusion the government should do nothing and not exist, rule of force and gang warfare is the route out. The system has proved that the divide between state and federal dosen’t work.
The desire for the current system to continue (as your posts show) is mainly fed by wild properganda about other countries (which typically are MUCH healtier than the US and for a lot less money).
Though the rest of the developed world and some members of the US who actually want a civilised society to live in, so health and educated. Which are two of the biggest failings of modern america.
As for your other opinions :
> Lack of regulation in banking did not bring the world to its knees. The central banks using fractional reserve lending
The “fractional reserve lending” that wasn’t regulated you mean.
> I don’t know much about England
It shows, as the post is about a comparison of the two systems from someone who has experince, and not from someone attacking a system with hyperbole source from Fox style propaganda.
> [government] …… control the lives of the citizens and destroy free enterprise.
This is bordering on tin foil hat wearing, the current demise of the US is the result of unchecked greed and selfishness and the selling out of the country to corporations. i.e. the US version of capitalism.
It just so happens with this form that people die
> Follow this to the conclusion: eventually we will all work for the government and be paid about the same while a very small elite group will control everything.
That is much of the US now. Most of the other countries that have proper health (and education) systems have much more social mobility than the US.
Not to mention decent public transport ……. but that is a whole different story (and typical US capitalist driven nightmare).
“[government] …… control the lives of the citizens and destroy free enterprise.”
It is bordering on tin-foil hat wearing. It also doesn’t stand up to scrutiny. When I speak to other freelancers and business owners in the US, they routinely say health insurance is one the biggest problems they face. Not only do they have to provide for themselves and their families, they are expected to provide for employees too. This is detrimental to free enterprise because it drastically increases their overheads. In effect, the majority of US businesses are expected to subsidise the health insurance industry; why is that? And how can it be described as free enterprise? It sounds like scrounging to me.
It’s quite refreshing to hear your views and you are very honest.
I live in London and i personally hate the NHS just like you use to. I have been living in France before and it is much better over there.
Such venom — typical…!
Being a British subject, I have too much pride to live off of the government (“…never give in, never give in, never give in…”), and have worked since I was 12yrs. old!
Actually, I have worked whilst ill (with lung infection/pneumonia), because treatment for illness in America is a privilege for the well-off! If one’s ins. co. discovers one’s illness, they’ll increase premiums or end coverage (of a self-employed person, not protected by a “group” policy)!
Therefore, 1/2 of my pay packet goes to the greedy health-ins. co., or else they’ll take everything I’ve worked for my entire life!
Consequently, I’m going home to the N.H.S., our fabulous health service — can’t wait!
Thank-you for clarifying my broad statement, Jerry, about “lack of regulation in banking….”
Albeit two years old from the NY Times, though the points are valid today and some of them are actually worse :
http://www.nytimes.com/2007/08/12/opinion/12sun1.html
[health insurance is one the biggest problems they face]
Indeed, let alone when trying to compete with the rest of the industrialized world where every other country has decided that a healthy nation is good for everything and one.
The US once again, stands alone. Now if its people stood together on interest opposed to division it might be different …
Oh WOW, this is so clever – you have the most gorgeous site here and I had to stop by to leave this comment for you – and to say hello of course ! Your posts are creative and original and you have interesting pictures. It’s all perfect ! Thank you for sharing your site and best wishes….
The fact that both overall and healthy life expectancy is longer in the UK than in the US suggests that the NHS must be getting something right!
One thing that most are failing to notice is that the UK does not have 20 million illegals (would be 30% of UK Population) not paying into the system, but still taking from it. If we had a 90 mile wide moat keeping people out, then the current system would be less taxed and US citizens would get better coverage at cheaper rates. Just go into an ER and see all the people getting “free” coverage now and every day. By free, I mean working people and companies pay for these costs. The UK also does not have a whole slice of the population addicted to drugs and shooting each other night after night after night. I pay to fix them up so they can live to shoot another night. The posts are great, but the countries are apples to oranges.
> 20 million illegals (would be 30% of UK Population)
Though is less than 10% of the US population, which is much less that the number not contributing to the UK system, and still using it.
US 0 – UK 1
> If we had a 90 mile wide moat keeping people out …….
Makes no difference in the UK, health tourism is alive and well from all countries, including americans coming over for so called “free” treatment.
US 0 – UK 2
> Just go into an ER and see all the people getting “free” coverage now and every day.
As is the same in every industrialized country in the west, though it’s only the US that claims to have a “real” problem with it …….. must be complaints from “real” americans …
No score, as the point was based in fantasy “there be dragons outside of the US, as I’ve never traveled or have no world perspective” land …
> The UK also does not have a whole slice of the population addicted to drugs …. night after night.
Never heard of binge drinking and fighting then ….. let alone been to any major city in the UK. It’s all Mary Poppins is it …… tsk tsk.
US 0 – UK 3
> The posts are great, but the countries are apples to oranges.
Indeed, the UK is a country where common support is accepted (by the vast majority) as the better way to raise the general level of the whole country.
The US is a place built on selfish profit, committed to defending any system (with wild propaganda) that provides that profit even if it means ruining millions of lives even to the point of ending a lot of them.
US 0 – UK 4.
Game, UK. US looses.
Luckily I’ve traveled the world (so don’t have what seems to be quite a common US myopic view of things), as well as having and lived in several countries (UK, Canada, France, Ireland). So have seen the best systems in the world at work.
I’ve had some experince of health care in most of them as well as others and I would choose all of them over the US in a heart beat.
And not because I’m some raging socialist liberal nazi from mars ……. but because I value living in a healthly educated society over one that isn’t.
Even at a very small cost to me overall, because one day it might be me or someone I know, and even if it isn’t I’m not a selfish greed ignoramus that thinks ill people just aren’t believing in the americon dream enough, or don’t believe in jesus, or are guilty because they are poor, etc….
That went out in Victorian England, just seems the US is regressing.
I somehow doubt the US population is 30 % illegal immigrants. To put it mildly.
Also, illegal immigration accounts for about one half of one percent of the US health care expenses. Given that those expenses are more than twice the size of the UK ones, that is hardly a point worth listing.
It is not really apples to oranges. There is an entire branch of economics out there called Health Care Economics that has spent a lot of time on just exactly comparing health care systems across the globe. Look it up.
In the meantime here is one of the better studies out there;
http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2008/Jul/Why%20Not%20the%20Best%20%20Results%20from%20the%20National%20Scorecard%20on%20U%20S%20%20Health%20System%20Performance%20%202008/Why_Not_the_Best_national_scorecard_2008%20pdf.pdf
[...] for another intriguing international perspective, check out “This American’s Experience of Britain’s Healthcare System.” At 315 comments and counting, readers are definitely engaged here and sharing their own [...]
I know this is not popular but our country is based on freedoms. We chose our paths heathcare is something anyone can get no one is kicked out of a hospital with no treatment. Free healthcare is a different story. How many people who can’t afford ins. have a car payment? Cable tv? eat out three times a month? I don’t have health ins. I pay my doc’s directly which is usually half of what they charge the ins co. I know things happen somethings we can’t control someone gets sick who has been healthy all thier lives. before we had across the board health ins. we dealt with doctors payment plans were arranged. It became a problem when the Goverment employees first got ins. through thier jobs and so on and so forth in a perfect world this wouldn’t even be a topic. but it’s not perfect and someone has to foot the bill. If the country had the money, maybe! But we all know we don’t no matter what our politians say Rep. or Dem.
The way I see it. We are responsiable for ourselves. We have lost sight of that.
Christina, Normally, I don’t comment on other people’s comments. It is my habit to leave my thoughts on blogs, read other peoples, and move on. In tis case, there is so much misinformation in yours that I feel it would be blatantly irresponsible for me to let your comment alone.
First, I’ll start with most probably have a car payment, cable tv, go out to eat three times a month. Since most of the studies found online are conducted by insurance companies themselves, the data is suspect, so I’ll write from anecdotal information, and not probable.
I travel full time, and have met people across America during the past year from all walks of life. Many times I have heard the same story. They never thought they would be in this position. They worked hard all their lives, paid their bills on time, lived within their means. Then, for no reason within their control one, or both of them lost their jobs. Either the company decided some overseas location was a better deal, the economy necessitated layoffs, or illness just made it impossible for one of them to keep on working. COBRA (Consolidated Omnibus Budget Reconciliation Act) kicked in after a layoff, but often the premiums are so high that a choice had to be made between a house payment or health insurance. The car that was purchased when they had that job is no longer a luxury, now it’s a double-edged sword – without it there’s no looking for a job, but with it, there’s no affording health insurance. If they let the car go back to the bank, their credit will be hurt, which may impact their chances of finding employment. In a competitive job market, any potential mark against them may be the one between feast and famine.
Last week, I met a man who was living in a Fisherman’s shack on Shelter Cove. He stood outside in the rain looking sadly at his three years old Honda while his clothes finished the spin cycle in the public laundry. He was 90 days passed due on his payments, and Honda credit wouldn’t work with him to refinance, to extend his payment period out over a longer period. He was about to be without transportation. He was already looking for work. Now that he was about to be without transportation in a town without mass transit, his future looks grim.
The secondpoints regarding cable tv and going out to dinner just seem petty and mean spirited – as if $50 per month were the difference between health insurance or not, so I will choose to ignore those, and move on to your next, and most incorrect point, the one regarding doctors charging half of what they charge insurance companies.
When a doctor contracts with an insurance company to see patients who are covered by its plans, in other words, to become a Preferred Provider, they agree to take a specific fee for a specific service. This is calculated based upon the part of the country in which the individual receiving services is living. For example, a Dr. performing a routine PAP smear in CO may be reimbursed $X, while a Dr. in NY may receive $Y. The insurance company takes it’s cue as to what is standard from Medicaire, a government run health care program for those over 65 and the disabled. The insurance companies are going to expect a good deal for allowing the doctors to see their customers, so even though a standard billing fee may be, for example, $250, the pre-agreed fee between insurance company and doctor may be only $50.
Now, if you as an individual go to see this same doctor, you have no negotiating power. In some cases, doctors are willing to work with individuals who are uninsured and lower their “standard fees so that health care is more affordable, but in this case, even if the doctor were to charge the uninsured patient half of what he charges the insurance company, the patient would be paying $125, or $75 more than the insurance company.
You are correct when you write “no one is kicked out of a hospital with no treatment”. What you fail to mention is the quality, and the quantity of care. Is triage really the same thing as medical care?
We treat the protection of “stuff” as a right in America. If a house is on fire, the fire department puts it out, no questions asked. The fire department doesn’t leave when there are still embers glowing. They don’t wait to arrive until the roof is about to collapse. They arrive as soon as they alarm is raised.
In the words of my father, who was a quadriplegic, “if we don’t take care of our bodies, where will we live?”
Mara, well done for addressing and replying to the ignorance out there.
If most of the US population stood up to the willful ignorance and typical protagonists who are trying to keep things as they are, I think things would be dealt with very quickly and the fringe elements would still be heard, but seen for what they are.
Interesting post and if you care for your fellow human beings you would pick the NHS.
However I think what is really needed in any discussion about changing the American healthcare system, is not a comparison with the NHS, as Strawberry said it is to the socialist extreme in Healthcare. But rather comparisons need to be made with health insurance based systems with government subsidies for the poor as in most countries in Western Europe. Personally if I were to choose any Healthcare in the world it would be Holland’s.
As a Brit who has lived in the States for over 40 years and having received healthcare both here and in England, I sincerely miss the NHS. I am most definitely not a socialist, and not even a supporter of the British Labour party, but nontheless, I firmly believe that a government should have the responsibility for providing healthcare for its citizens as well as defending them.
In all the plans being considered now, I do not see the single payer option or anything really resembling the NHS being offered. Basically private insurance is still to play a large part in healthcare reform and I am amazed at those who speak so adamantly against even being offered a public option. Note the word “option”. That is a choice. It is not for everyone, nor is it meant to be, but is for those not fortunate to be able to afford private healthcare.
That being said, I personally do think that government could oversee healthcare every bit as well as the private health insurance companies, whose only interest in insuring people, quite honestly, is to make profits. I think it is morally wrong to be making huge profits out of people’s misery.
I know I would far rather that the money I pay in healthcare premiums go in taxes, and healthcare be provided for all, rich or poor, in healthy or sick, alike. I speak as one whose family does have a very good health insurance plan. Despite that, because of having a dependent with a serious chronic disease, we regularly hit the maximum catastrophic cap before the year is half over.
Still, like so many people, we live with the fear of what would happen if my husband were to lose his job and if we were to lose our health insurance. We are the fortunate ones. My heart goes out to those who cannot afford healthcare, and live with constant pain and stress. How can a nation not have compassion and endeavour to help them. What can the American people do to help those people?
I’m not seeing any links to statical or economical data within this article to substantiate the claims. I see a couple of Wikipedia articles but that’s it. Please provide links to reliable sources that have actual hard data that can make the comparison to other health systems.
As I see it, and you have admitted, much of what has been said is anecdotal. What you have written seems very positive and cheery, but without actual data, it means very little to me. Like many here, I want to make a well informed decision within this debate. I’m open to both sides, however I’m not seeing the “other side” represented here and so this article, along with its comments can also be seen as “propaganda.”
Concerned, I think you may be looking for this blog-post to be something it’s not. I wrote this as an emailed reply to a friend who was asking for my personal experience of Britain’s healthcare system, and that’s exactly what it is — my personal experience and a very true rendition of it. In that respect, hard statistical data is irrelevant — my experience is what it is. If this post seems positive and cheery, that’s because my experience of British healthcare generally was. And though I did note that there are negatives in the NHS — some very big negatives — that is countered by the fact that I have experienced very similar negatives here in the US as well.
It’s easy to get the hard data if that is what you are looking for — a simple Google search with serve up an abundance. These links may be more what you are looking for:
~~This article from the very well respected Economist has a lot of links to the kind of hard data that I think you’re looking for: http://www.economist.com/blogs/democracyinamerica/2009/09/cancer_health_insurance_bankru.cfm
~~This blog-post defines and describes the various healthcare models that other countries employ, as well as pointing out that the Canadian system is not actually a socialised model: http://www.blogher.com/debating-health-care-reform-what-can-united-states-learn-rest-world
~~This blog-post addresses the vexing question of what “universal” healthcare actually is: http://opportunityagenda.org/when_insurance_isnt_enough_what_universal
It is a wonderful to hear that you are keeping an open mind on this subject and that you want to make a well-informed decision on this issue — that is truly commendable. And hard data will help you in that process, but it is important to remember that the purely anecdotal has a valid part to play as well. The former tells you how well a healthcare system is working overall, but the latter tells you how well it is working for the people at a grass-roots, individual level. It shows you how the people who live with such a system feel about it, and that’s exactly what the comments section does here — all the positive and negative replies adding up, not to some devised propaganda, but to an unorchestrated truth.
I was about to reply stating much of what I now see Strawberry has said. Statistical data is beyond the purpose of the original post.
I am puzzled as to how and why you would interpret the comments by hundreds of individual people as propaganda. I have read all the comments, and “the other side” is represented. That it forms just a tiny fraction of the over all total may be the reason you have missed it. That it forms such a small percentage indicates the overwhelming positive opinion those who have experienced the NHS have of that organisation.
Is it perhaps that such a positive opinion of the NHS clashes so powerfully with preconceived ideas you have about “socialized medicine” that you would instinctively prefer to conclude that what is obviously the uncoordinated opinion of hundreds of people from all walks of life must in someway be “propaganda”? If so how? urself who could be organising this propaganda and to what end? Then the very idea becomes silly.
You can read about my experiences with the NHS elsewhere among these comments. Other comparable comments strike me as absolutely authentic and believable. I am putting my own name to this because I believe in standing by what I say absolutely. You can look me up, see who I am, email me and debate any point you wish. If, that is, you are likewise prepared to tell me who you are.
I cannot praise our wonderful NHS enough. It cared for both my parents in the latter stages of their lives with dignity and compassion that I could not fault. My Father went into slow decline and finally ended úp in hospital for 2 weeks after which he had to go into a care home. For the first two months we had to pay the costs of this, about 2,500 pounds per month, but then the state took over the funding as he was deemed to need medical care as well as nursing care. For 8 months this was paid until he finally died. He had been diabetic and all the necessary medication was paid for by the State of course, as were the many checkups for associated diseases.
Our National Health Service is something we Brits treasure. Woe behold any politician who would try to destroy it in favour of a privatised system. Come on Americans, fight for it!
I spent the day at meetings in support of a “Public” Health Service, telling that we don’t let our elderly die in the U.K., because “health-care is denied” them!
Then, I heard the discouraging news that many of the politicians who voted AGAINST A “PUBLIC OPTION” in the Sen. Finance Comm., were Democrats, including the
chairman!
There are many lovely people working very hard for that plan, but so many people are so uninformed, that they believe all the rot told by the greedy ‘health’ industry!
They don’t even know the ‘health’ ins. companies are exempt from Anti-Trust Law, meaning they can have a monopoly! Some states don’t allow them to be sued for NOT paying for the insured patient’s care, etc.!
People can’t afford ‘health’ ins., but don’t want “the government in their lives”! They want their “freedom” to not be unable to afford health-care, but think the ‘free’ E.R. (A/E) will look after them, which is paid for — although they’ll get a BIG bill, they probably can’t pay! — by people who are insured (approx. $1,000 “cost-shifting” per year!)!
Many of the people who are so, very opposed to “socialized medicine” already have it in Medicare (elderly) and V.A. (military), because they DON’T UNDERSTAND what they’ve got! Nor do they understand that taxes subsidize wealthy ins. (Advantage) and pharma. (Part-D)!
It’s mindboggling and so, very sad. Lambs to slaughter.
I am all for public universal health care and am sure it’s great for citizens, but there is a flaw with the NHS that is not well known.
I am a American student studying abroad for 4 months and have been denied health care in every public clinic and GP. Because my Visa does not last 6 months I find myself paying out of pocket at private places. American students are poor. I have 75k in loan debt and am paying for medical care with my student loans and credit cards. My ISIC card only covers me only in situations similar to having bullet to your head in an ER. My American Insurance (bluecross bluesheild) might cover me if I’m lucky but I won’t know because I have to file a claim and would have to wait months hoping to get my money back. This is money I need now for living. So when I spend and entire week missing classes because of searching for health care and being turned away, it is very frustrating and devastating. Specialists tell me I need to see my GP first. GP’s tell me I’m not here long enough and can’t be registered. It’s a never ending cycle. I have given up and decided to wait for care and proper diagnosis.
I feel like nothing has changed with health care since leaving America. No one will see me and the costs are too high to pay to get treated. Getting a simple blood test for pregnancy was $90. I shutter to think what an ultrasound would cost. I know it’s at least $500. So I will deal with my pelvic pain, fever, frequent urination, amenorrhea (stop menstrating), as well as other symptoms that have suddenly appeared for 3 more months. Hopefully whatever cyst I probably have will not rupture in that time. At least if it ruptures I will get care because then it will be an emergency. That’s all you have to do is wait for a problem to become an emergency here. So in the end, I might get treatment.
A word to the wise, if you travel in the UK for less than 6 months, don’t you dare get sick.
Carolyn, I suspect the problem you are facing is really about the kind of visa you are on. If so, then it is not an issue/problem with the NHS. The NHS is freely available to all permanent residents of the UK (note: not all citizens — even those holding UK citizenship must be currently resident in the country in order to be eligible for NHS care), and those who are on certain types of visas, such as tourists and perhaps students, do not qualify as permanent residents and therefore are not eligible for NHS care.
But even if that is the case for you, it is important to realise that this is not a problem with the type of healthcare system the UK has chosen to employ. It is strictly down to the rules surrounding immigration and visas — a completely separate area and department.
Having said that, it may be worth speaking to a local doctor about your health issues while you are there, as it is often left to the individual doctor’s discretion whether or not to charge a visitor. People who travel to the UK specifically to receive healthcare will be charged, but those visitors who are unfortunate enough to genuinely fall ill during a holiday often aren’t. Over the years, I have had three visitors who fell ill while staying with me, and I took them to my doctor and, each time, he treated them at no charge.
“I am a American student studying abroad for 4 months and have been denied health care in every public clinic and GP.”
So you turn up from a different country that does little more than tell everyone how amazing it things it is, and expect everything for free ?
The NHS is abused daily by health tourists who come from other countries because the systems in their countries are such a joke (i.e. the US). So there have to be some limits against people who expect everything for nothing, and especially when they aren’t even part of the system and don’t contribute to it.
“A word to the wise, if you travel in the UK for less than 6 months, don’t you dare get sick.”
A word to the typically self entitled american ……. if you are a tourist (short term stay) get travel insurance, just like everyone else.
Let alone the obvious omission that you would be cared for in A&E and not charged a penny, mores the pity.
Carolyn:
Blue Cross/Shield is a very wealthy company and paid for an American man, injured in the Bali (sp.?) bombing, to be treated and transported to the U.S.
You may not have educated yourself about whether they’d pay for your medical treatment abroad, but they might pay “out of network” minus your deductables.
It’s worth a try, but you must pay for private treatment, as you would have to in America, just as my student daughter has to. I’m still paying bills for her op. and we have ‘good’ (very expensive!) ins. in America.
It really isn’t fair to expect British tax payers to pay for your treatment, except in an emergency. In America, British people have to pay for private treatment, even in E.R. (A/E), so buy health-ins. to protect themselves whilst there.
Your health is more important than your education.
this is a great share ! thanks!
Don’t mention it.
An after thought is that there may be a back-wash from the wicked lies told about the N.H.S. in America, causing even the Prime Minister to comment on We Love the N.H.S.
Sadly, doctors might not be so kind about not charging Americans who become ill whilst in the U.K., because of those verbal attacks on our health service, which is far superior to the extremely expensive, private system (except military, elderly and poverty-stricken) in America.
It is astonishing that so many Americans have NO health-care whatsoever, unless they become so ill that they go to the E.R. (A/E), where they still get a terribly expensive bill!
Very sadly, there are so many premature babies born in America, causing the dreadful infant-mortality rate (amongst all races), but Republican politicians boast that they have the best ‘health-care’ in the world! (Maybe they do!)
Why aren’t all Americans outraged by those babies dying, instead of (some) being outraged by possibly a “public plan” for people who can’t afford private ‘health-care’?
[...] found an awesome post on health care in Britain. I don’t think Americans are really getting the true feelings of most of the people that are [...]