To feel sorry for American's as their healthcare system appears abysmal

[Wowthishurtsalot]

I'm a member of a support group for a health condition I have which is fairly rare, this support group attracts a global network of posters who draw on it for support and advice.

The American posters almost all have the same complaints:
'My insurance won't cover a referral to the right specialists'

'My insurance only covers one prescription a month so I have to pick and choose which attack I use it on' (the condition can mean you'll have several attacks or flares a month)

'I've had to quit work, I have no insurance and therefore no meds'

'My insurance doesn't cover/considers these meds non essential'

It's appalling. Its a condition that renders its sufferers in hospital several times a year but with the right medication can be managed. It can, in its extreme form, kill or trigger a life changing side effect.

How does that country function?! I Really count my blessings and am so grateful for the NHS when I speak to american sufferers or carers. AIBU?

[DoJo]

I saw this video yesterday and found it really interesting - I haven't had time to do all the supplemental reading, but would be interested to hear others' thoughts: www.upworthy.com/his-first-4-sentences-are-interesting-the-5th-blew-my-mind-and-made-me-a-little-sick-2?c=reccon3

(Ignore the over dramatic title - it's just a guy talking about healthcare in the US!).

[SmashleyHop]

Each system has it's ups and downs. Being American and living here now I absolutely believe that is true. I was low income in the states for a time. Was on Medi-cal and had everything covered. I didn't want for anything. Then had a great insurance when I got a good job- again didn't want for anything. The care I received and gave as a health care worker was top notch.

Moving here I've had a few experiences with the health care system and I don't have many complaints. Went to a fantastic women's hospital in the NW and will forever sing their praises. I was frustrated at the wait times for specialists and tests though. Especially when my eldest had a very suspicious lump in his throat that we suspected was cancer.. thank goodness it wasn't. Three months to get an ultrasound seemed crazy to me. However yet again I will sing the praises of the operating and recovery team for my sons treatment.

There are holes in every system and horror stories to accompany them. Not better or worse, just different. That's just my opinion as someone who's worked in healthcare and been a patient in both countries.

[theoldtrout01876]

I used to have a great insurance,now its crap.

I have a good job and have been there a while. I have found most work places are dropping their good coverage.

When obamacare kicked in insurance companies upped their premiums hugely to compensate. Employers looked for cheaper options.

I now pay $360 a month for a family plan,quite cheap I hear you say BUT my 360 a month plan pays for NOTHING until my family has met $4000 a year deductible. Thats all fine if one of us needs to go into hospital,has an accident or a major illness ( though we would still have to pay that $4000 before coverage kicked in,even then they only pay 80% of some stuff even after deductible,but hey on the bright side my annual out of pocket expenses cannot exceed $12500 )

I cant afford to go to the doctor even with health insurance. If you go for a physical they want all kinds of other stuff done too as part of it. EKG,chest x ray mammogram etc, all of which I need to pay for. If you go for a sick visit they wont see you till youve booked a physical

It sucks. I have rheumatoid arthritis and have not seen a doctor or taken any medication in 2 years now

[phlebasconsidered]

I am lucky: I have a condition that requires I take medication to sustain life. I get that for free. In the USA, i'd pay, and it's expensive. I am a member of several groups around the condition, and the USA patients that can pay get great care, above and beyond the UK, but those that can't get the basics and hence live forever under the par, feeling crud, or ill. I am lucky, the NHS has paid for me to get the daily medication AND the additional meds I need, without which I would still be in bed all day and ill, but "functioning" and so ok. In my case, the NHS has been wise. They have realised I cost them less healthy: working full tiem, functioning. Sure, I cost drugs, but I am well in every other way. All my poorer USA "friends" who have the same condition are stuck: they don't get the good care, they can't get the best, they get to stay alive, but not to function, for free. No fair.

[Kundry]

DH lives in Germany - his insurance is very expensive, doesn't cover everything and the sheer waste of money is hard to believe.

No, you don't wait for much but an enormous amount of pointless healthcare is carried out simply so it can be billed for. One minor op - in UK would have been 2 appts max turned into a mammoth affair where the wound was rechecked pointlessly every other day for weeks. God knows how much was claimed from the insurers for that scam.

And the quality is not as good. DH has serious eye problems and requires surgery. It quickly became apparent there that the specialist had far less experience than a jobbing doctor would here as they simply see far less patients and so have much less experience of operating. We also discovered that you get less good care depending on what type of insurance you have - DH's wasn't the best and he was beeing seen by a very junior doctor and basically left to go blind.

No-one in the UK has the foggiest idea how expensive healthcare is and how lucky they are.

[CasperGutman]

I'm a little surprised by the lack of imagination on the part of those who say the American system is good because they had insurance and got top quality care. What if you were one of the millions who fell through the gaps?

The system must be judged taking into account its pros and cons. If people like theoldtrout above miss out on medical care they need, the system is not a good one, even if the outcomes for some are exemplary.

If NHS hospitals turned away every other patient on the basis of a coin toss and spent the money on those who were allowed in, the treatment the lucky ones received would be better. That doesn't change the fact that this would be a stupid and unfair system.

[shebird]

It is true no healthcare system is perfect but it seems to me that often the American system seems to add in unnessesary extras for routine things. As theoldtrout has said a full physical is required before a GP visit with very costly tests.

[LongTimeLurking]

YANBU. The depressing thing is politicians of all parties have been trying to move us closer and closer to a US style market driven system for decades. The current government pretty much hammered the nails into the coffin recently by forcing the introduction of even more 'competition' (i.e. private companies get to pick off the profitable bits and the price of everything else soars).

Soon we will all pay massive NI AND have to stump up for private insurance.

[maggiethemagpie]

I have diabetic eye disease, which can lead to blindness if untreated. I would almost certainly be blind by now if I had not had treatment, some private but some on the NHS. I was on a forum for people with this condition and one lady said that her retina started to bleed and she was on her way to the hospital when she got a call from her insurance people to say she was not covered. This resulted in sight loss for her. Horrendous.

[Momagain1]

YANBU,

The NHS is one of the reasons we chose to finally return to dh's country rather than live out our lives in the US. Even when his career path finally brought us to the level of relatively good insurance, decades of minimal insurance, and a hesitation to use even that, because of the upfront costs that may, or may not, be reimbursed later, mean I was trained to ignore symptoms. It goes back to childhood really, as my parents were poorly insured or uninsured so I grew up with the standard that anything other than unbearable pain or unstoppable bleeding was ignored. I was always a bit amazed at classmates who saw doctors regularly, thinking they must be quite sickly to need to see a doctor.

After over a year here, I have begun following up on my ongoing, but not debilitating, symptoms.

[lljkk]

I have several American relatives with complicated & very chronic diseases & on welfare and... they are fine. They get excellent care that they need. I think it might be regional, though, from things I've worked out, the state govt. may top up for gaps in federal coverage. So then it depends whether you live in a rich state (like my relatives do).

[Momagain1]

Old trout: the deductible is the cruellest part. Avoiding treatment knowing that it will cost less than the deductible, but more than you can pay, turning the payments to buy the insurance into pure profit! At one point, my dh had insurance through his employer, me through mine, and DDs through their dad who was in the military in another state. Coordinating the so-called family maximum, based on the varying deductibles and payment plans and separating my girls from the rest of their dad's family was horrible. And my family maximum was different, and included different things than dhs, and DDs had to be coordinated with ex, meaning we both had to share medical information about our selves and our new partners with each other. i was no better at that than he was, many years it never got properly sorted, meaning we both paid out of pocket for things we might not have had to.

The one situation we pursued no matter the obstacle was mental health care for one DD, I felt like being the family insurance clerk was a part time job, and in the end, what made it really work was that the military insurance assigned her treatment to a teaching hospital, which then wrote of some costs because we accepted supervised students rather than actual doctors in some situations.

[Momagain1]

Ljkk: indeed, medicare varies by state. They are lucky if it is working for them, I hope it continues to.

[zeezeek]

As someone who works and researches in the NHS it is heartwarming to hear so many people praising it, because, at the moment it is so often the case that all we hear is what is going wrong. I have a bit of experience of the American and the Swedish healthcare systems and can see good and bad in both. Just like I can with our own NHS. None of them, ever, is going to be perfect and none of them ever is never going to make a mistake.

What needs to be remembered, IMO, is that we have something unique in this country: a healthcare system that really is completely equal and, for that, we should be thankful.

[MehsMum]

YANBU.
I had DC1 in the UK, standard midwife delivery in an NHS hospital. I went to live in the US soon after, and joined a mother and baby group. One afternoon we all sat around talking about our deliveries, what our insurance had covered, what it had not, how the one of us without insurance had had her sister (a midwife) come to stay and deliver her (even though, in the state where she lived at the time, her sister was not licenced to practise). Then they all looked at me. 'How does it work in the UK?'
'Uh, you go to your GP - your family practitioner - and get passed on to the midwives and then-'
'Midwives! Like, that's normal?' (US standard: obstetrician does the care and delivery. Leads to a high rate of sections. Midwife care is unusual and, in some places, unobtainable).
'Um, yeah. And then usually you have a midwife delivery in hospital.'
'Do you get to choose your hospital?'
'Yeah...'
'From your insurer's list?'
'Er, no, we have the NHS. You can go where you like.'
'Does it cost extra?'
'No. None of it costs anything. Even dental work is free when you're pregnant.'
'FREE?!'
'All of it, yup. Doesn't cost a penny.'
'But what if you have complications? Section? Baby is prem? SCBU? NICU?'
'It just happens. You don't pay anything.'
'No deductible?'
'No what?'

We had decent insurance, but I still got a bill when I had a miscarriage and needed a D&C. The care was excellent, though. Yet there were people around who clearly weren't getting any medical treatment at all. Our upstairs neighbour went through hoops over medical insurance, because she'd once had a dodgy cervical smear.

The NHS is not perfect, but every time I go the GP, or take one of the DC there, or to A&E, I count our blessings.

[Suzannewithaplan]

I dont think the NHS is a luxury, we should expect as a matter of course that a modern wealthy country can organise itself such that it provides free healthcare

[SaucyMare]

I used to have a great insurance,now its crap.

I have a good job and have been there a while. I have found most work places are dropping their good coverage.

When obamacare kicked in insurance companies upped their premiums hugely to compensate. Employers looked for cheaper options.

I now pay $360 a month for a family plan,quite cheap I hear you say BUT my 360 a month plan pays for NOTHING until my family has met $4000 a year deductible. Thats all fine if one of us needs to go into hospital,has an accident or a major illness ( though we would still have to pay that $4000 before coverage kicked in,even then they only pay 80% of some stuff even after deductible,but hey on the bright side my annual out of pocket expenses cannot exceed $12500 )

I cant afford to go to the doctor even with health insurance. If you go for a physical they want all kinds of other stuff done too as part of it. EKG,chest x ray mammogram etc, all of which I need to pay for. If you go for a sick visit they wont see you till youve booked a physical

It sucks. I have rheumatoid arthritis and have not seen a doctor or taken any medication in 2 years now

this is my friends experience, every year their excess goes up with their company insurance.

he has bad asthma and has to pay the $200 for each inhailer, for which he needs 24 a year as each one only lasts a month.

[lljkk]

I'm not sure the Brits should be so against co-pay. A modest fixed co-pay would not be same as paying thru the nose or having privatised health care, but it would mean that those of us who can pay something would (& should). I think Britain & Canada are about the only countries where healthcare is free at point of delivery & it isn't a perfect model, either.

If co-pay were such a disincentive for preventative care then Britain should have ideal stats for preventable diseases and early diagnosis; but Britain's record is not the best in those areas, even.

Something to ponder: the Americans think that cost-effectiveness-calculation in provision of health care is an abysmal idea. That you can try to put a price on the value of years gained or lost in deciding what care to offer, or the value of a human life; it's considered abhorrent and the govt. of all institutions has no business trying to decide those things. But it's what NHS economists have to do all the time & is widely accepted throughout Europe, too. Because cost-effectiveness makes sense in socialised medicine, when the service has a duty to taxpayers to offer best value.

[ElkTheory]

The quality of care in the US is generally excellent. The system of paying for health care via private insurance (usually through one's employer) is insane. The Affordable Care Act is a weak, shaky step in the direction of better coverage for more people. Insurance companies can no longer deny insurance to someone because of a pre-existing condition, for example. The US has a long way to go, though at least the ACA is a (tiny) beginning.

Unfortunately, generations of politicians and lobbyists have managed to make a lot of people scared of "socialised medicine." When in fact, that is exactly what the US needs IMO.

[Mumpire5]

I haven't read the thread but yes I think it's disgraceful that such a wealthy country doesn't look after its old and its sick and its poor. It is absolutely shameful.

[scousadelic]

We have friends in the USA who have also lived in the UK, their opinion was that both systems were good, the NHS was more reliable whereas the US system was very variable. For those with good insurance it could be better than the NHS as it often embraces new diagnostics and treatments quicker

One of the biggest problems the NHS faces is that many patients have no concept of costs and so don't properly appreciate their treatments. I regularly see people who fail to attend appointments, who lose expensive medication or devices and want it replacing free of charge, over order prescriptions, etc. If we could get rid of a lot of the useless management and get patients to value their treatments more I think we would be in a far better position

[fasterthanthewind]

scousadelic - I was about to agree heartily with your idea of putting prices on prescriptions/devices etc (not so that people paid them, but so that they could see what they cost).
But then I thought of all the drugs that really don't cost much, but for which you have to pay a full prescription charge. I think the resentment of the over-payment would far outweigh any gratitude for under-payment!
What do you think? Prices only for really expensive stuff??