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.
———————-
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.
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.
I think the days of the employer paying insurance for employees is coming to and end. One of the reason fro Chrysler been outsourced to China was to due to the lower labour and overhead costs of the Chinese market. Employers will ever seek to reduce labour costs and overheads to compete in the global market. Therefore they will no longer be able to afford the cost of insuring their employees. Thus the case for an NHS is ever more needed.
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.