Saturday, August 15, 2009

On being treated in the UK vs. the US

Chris Hansen writes on his experience with National Health Service in the UK vs. the US non-system (posted with permission):

As a happy consumer of the services of the National Health Service, as well as a dual US/UK citizen who's experienced health care in both places, I'm happy to weigh in on this one.

I have been a diabetic for more than 25 years, I believe. My US internist in New York completely missed this when I reported my first symptoms to him. His attitude: I can do a test if you like but I think it's in your head. No, Dr., it was in my pancreas.

When I was then formally diagnosed in Chicago in 1991, my internist prescribed a high blood pressure medication that is contraindicated for diabetics. My internist in San Francisco in 1993 took me off it immediately.

When I had diabetic retinopathy in Chicago in 1992, my internist sent me to an ophthalmologist, who looked at my eyes, charged me $80, and said, "I'm not a retinal specialist--you have to see Dr. Y." I went to see Dr. Y. He charged me $1300 to have laser surgery on my eye, of which around $800 was paid by my insurance. He did good work (ophthalmologists still exclaim over it 17 years later) but I did pay for it.

When I got to London I selected a GP's practice, and they started me on the same medications I had been paying around $100 a month for in San Francisco in 1993. I went to the drugstore, handed in my prescription, and said, "How much do I owe you?" "Nothing" said the pharmacist, "All diabetics get all medications free for the rest of their life." And so it was. I've never had to pay for any of my medication here. I offered him money anyway, as I could have afforded to pay, but he wouldn't take it.

When I had my heart attack in 2006, I was given angioplasty and a stent within an hour of being admitted. I was in the cardiac intensive care unit for 2 days and the regular cardiac ward for three. Total cost to me: £0. As of now my heart seems to be in good shape. They got me out in time for our civil partnership ceremony on Valentine's Day.

This morning I went to the diabetic foot clinic at Kings College Hospital and was enrolled in a study to see whether a treatment is efficacious on foot ulcers. I got the treatment, dressing, and a boot to take the pressure off the ulcer. Cost: £0. I am currently unemployed, and in the US I would have been unable to afford health insurance for any of this. In fact, they're paying me to be in the study.

I have had some odd moments in the UK health system, but nothing life-threatening.

The NHS works, sisters and brothers. It is one of the most unselfish things any government has ever done for its people.


IT said...

I concur. I lived in Britain for 4 years. The care was excellent, and I wasn't burdened with paperwork trying to figure out who paid what.

brian said...

How would you compare it with France, Germany's or the Canadian single-payer system?
It's important to be accurate: you DID pay for your medicine and other treatments. You paid your taxes and fees.
It's not a question of the government getting to keep the money it doesn't spend at the end of the month, so 'generosity' doesn't describe this. The government decides which system saves the most money to get as many people as possible a way to have as high a quality of life as is consistent with nobody (either government or individuals)going broke, encouraging healthy behavior and saving time and aggravation.

Grandmère Mimi said...

Ann, thanks for posting this. There is no way we will get a single payer plan through Congress, so when folks rant about that here in the US, they demonstrate ignorance. It ain't gonna happen. I wish it would, but it won't.

I hope we find some way to give everyone health care coverage. The right to health care is a moral issue, whether you're religious or not, if you are a person of principle, with any sense of fairness. We have pretty much lost any notion of the common good in this country. It's dog eat dog, and I've got mine, so the hell with you, and frankly those attitudes make me sick.

Thanks for a space to have my little rant.

IT said...

Mimi, sing it out. I agree. Of course we all pay for it , one way or the other. Right now we spend a larger fraction of our GDP on health care and vast swaths of our population hasn't got any. People go on and on about 'rationing health care'. Newsflash! We ALREADY ration health care economcally. But as you say, the attitude is "I've got mine."

Sadly, most of hte poeple who think "they've got theirs" are one serious illness away from bankruptcy. They are far more at risk than they realize.

Brian R said...

I wish this other brian would change his name. Since Australia gained universal health care in the early 70's sure I have paid a health levy on my tax (now 1.5%) but I have been able to rest easy knowing that my financial planning will not be destroyed by some unexpected illness. I am also glad that my less fortunate neighbours are able to gain the same health care even if unemployed. Now that I have retired, I no longer pay the levy and actually most health care costs zero. Rather than age being a barrier to some procedures as I read is being put forward by liars in the US, age brings advantages and more care.

lasthussar said...

Brian (no R)- obviously you pay through taxes- there is no such thing as a free lunch. What there isn't is a hospital admin coming to you and saying- "The insurance has ran out." and then giving you options on either remortgaging your house to pay for your parents care or letting them 'home to die', or while your seriously injured child has been rushed into theatre asking how you will be paying- both of which I have seen posts saying happened to the poster.

There are not arguments about what treatment is covered, and how much. When you are ill the first thought is not "Can I afford this?".

Another criticsm levied at the US system is that tests are prescribed, whether needed or not (See New Scientist) because there is a profit incentive to do extra tests- 'never ask the barber whether you need a haircut'.

And here's the kicker- The US spends twice per head than the UK. Half of the US spending is GOVERNMENT spending. You are already spending as much tax as we are.