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?

[wonkylegs]

The American system is weird and seriously flawed however a lot of Americans are very anti- anything that has a whiff of socialism hence their resistance to socialised healthcare or social care.
I have a long term health condition and without doubt I have the best access to care/medications here in the UK. I also belong to an international support group and some of the stories of sufferers in other countries is shocking and saddening.
There is also a tendency to over medicalise in the US as there is a profit element to care, DHs American cousins often get offered an expensive medical option first rather than the simpler care they would get to try here first (DH is a dr so it's often discussed)
The NHS has also fantastic bargaining power (largest single provider) so manages to get much better deals on drugs and equipment than other countries.
The NHS also despite what MPs /popular press would like you to believe pays it's medical staff less than many other countries. Making it's relative overheads less. DH could earn at least twice his current salary in the US for less hours but he didn't go into medicine for the money alone and both of us completely believe in and support the NHS.
It's worrying what is happening to the NHS.

[BeyondPreparedForHell]

Piglet, cuba apparently has surprisingly good healthcare - as a communist country i guess its in their interests to keep everyone healthy enough to work. The cubans i know were shocked to find i was on the cheapest dmards from the nhs, as for cubans they start with the most likely to work.

[PigletJohn]

it's not just communist countries that want to have good universal healthcare, or are willing to pay for it.

[PigletJohn]

US neonatal mortality is worse than Western or Eastern Europe - Belgium, Belarus, Bosnia, Croatia, or even Cuba

I'm sure if you are in the US and can afford it, you can get decent care.

[Downamongtherednecks]

The point is not just your insurance though. It is the kind of condition you get. Anything long and expensive will mean you reach your insurance maximum (maybe 1 million dollars) per condition, so even if you are middle class, well-insured, in work etc, a chronic condition can leave you medically bankrupt. I know at least one couple who divorced while the wife had cancer, so that she was left "destitute" with no assets and would therefore qualify for state assistance with medical bills -- they could not have afforded her care otherwise. They remarried once she was well. We have very high-level insurance here, (I insisted on it before agreeing to the move) but if the dc got anything long-term I would take them back to the UK (we still pay UK tax and NI).

[Nancy66]

Sicko the Michael Moore film is worth watching for those who haven't seen it (entire film available on Youtube.) yes, it's flawed like a lot of his work but it's still fascinating.

Stories of US citizens left absolutely destitute because their insurer wouldn't cover their cancer treatment as they'd failed to declare a totally irrelevant illness from years earlier.

I needed medical treatment when I was in the US one time. I had insurance so it didn't cost me but they charged insurers a fortune - something like £9k for treating a dog bite.

[SconeRhymesWithGone]

I sometimes ask if these people object to a Socialised police force, or a socialised fire service, or socialised street-lighting.

Or socialized education.

The parts of the US health care system that actually work fairly well are the parts that are government funded.

[BoomBoomsCousin]

Are neonatal mortality rates comparable? Several years ago I thought there were problems of differing methodology due to the U.S. being more prone to taking extraordinary measures and counting babies born at a younger gestational age in mortality figures (while other countries would count them as still births)? There are also factors in the USA that other developed countries don't tend to have to the same extent (such as relatively high rates of immigration from less developed countries and of obesity and drug abuse) and which would produce worse outcomes even if the level of care were equal.

I'm not arguing here that the USA's health system is good at all, just that not all criticisms and comparisons of it are reasonable or enlightening.

[CheerfulYank]

It depends on where you are, Piglet.

I described giving birth in the US...big private room, good food, attentive staff, etc etc. The most stereotypical "poor" mother I know here (three kids in three years, generations of unemployment, blah blah) received the exact care I did.

[MewlingQuim]

YANBU

But I think the NHS should give all patients an itemised bill for treatment, not one that has to be paid but just so that people understand the costs involved in their care.

I think itemising treatment costs for each patient would also help reduce wastage within the NHS.

[SconeRhymesWithGone]

Just to reiterate; new mothers do not stay in hospital in the States for a week unless there are complications. 1-2 nights for vaginal delivery; 4 at the most for a C-section.

[FangsForBloodyNothing]

Magic you are very lucky with your story!My aunt in Ireland was diagnosed with bowel cancer 2 weeks ago but has health insurance etc so she had her scans etc immediately and is having her surgery tomorrow...she asked her consultant last week what would have happened if she didn't have the health insurance?He told her that unfortunately there is a 2 yr wait currently for bowel surgery

[CiderwithBuda]

CheerfulYank - thank you. That is very kind. I will try to work out how to link to it. Will PM you the details.

[wonkylegs]

Beyond your DMARDs will not be chosen because they are the cheapest. There is a risk / reward basis for prescription not necessarily a cost one on the NHS. The most effective DMARDs across the board for my condition also are the cheapest. However when they stopped working for me the NHS funded my extremely costly anti-TNF drugs - because they work for me. But it would have been daft to see if they worked first when a cheaper drug could of (& did) work first.

[Kendodd]

I have experience of paying for private treatment in the UK.

My daughter had glue ear and was being seen by the NHS ever few months to check her hearing, always seen in a sound proof room with very sophisticated equipment. Her hearing was just scraping along the bottom of the normal range, not really enough to justify and operation, more wait and see if it gets better on its own. Finally the consultant (who was great) thought as it wasn't improving she should operate. I was told it would be about a two/three month wait.

It was just coming up to the summer holidays and we wanted the op do before she went back to school, DH had private health insurance through work so we decided to have it done privately so we could choose the date. I contacted the insurance company and discovered I had to jump through numerous hoops which all took weeks (letters from GP, hospital docs, etc). Basically they were just looking for any way they could to get out of paying for it and turning us down. Eventually they agreed to pay and we could book a date with the hospital and the consultant and the hospital had to book a paediatric nurse, so another couple of weeks for all availability to coincide.

Straight after the NHS consultant had spoken to us about an operation I called the booking office contact thingie place and spoke to the admin person in there. She had said she couldn't give us a date just yet for the op so I told her we wanted it done as soon as possible in the summer holidays so if they had any cancellations please call us.

The NHS admin person called us with a cancellation date that was BEFORE our private date which was now booked in. I didn't take it because we were already booked into the private hospital.

My daughters treatment all went well but I think it would have been better under the NHS, afterall, it could have been done by the same doctors. They would have had a dedicated children's ward all set up to make children feel as comfortable as possible. She would have really loved that. Her private check up a few weeks after the op consisted for the consultant whispering behind each ear while the traffic roared by outside, no fancy computers or sound proof rooms.

Oh and we still had to pay £500 excess.

Give me the NHS any day.

[PigletJohn]

I don't know the figures, but IME most NHS use is small cheap things - flu jabs, tennis elbow, asthma inhalers, vaccinations, whatever. At the beginning and end of your life you may need more.

But if you ever need an air ambulance, complex operations, ITU, a month or two in hospital, it's there for you. Nobody asks for your credit card number at the desk.

[Suzannewithaplan]

But if you ever need an air ambulance, complex operations, ITU, a month or two in hospital, it's there for you. Nobody asks for your credit card number at the desk

reflecting on that makes me realise just how well cared for we are, of course we take it for granted and are generally unaware of how lucky we are compared to other countries.

I still maintain that free health care ought to be a right and not a privilege in a modern wealthy country

Also agree with this from Mewling

'But I think the NHS should give all patients an itemised bill for treatment, not one that has to be paid but just so that people understand the costs involved in their care.

I think itemising treatment costs for each patient would also help reduce wastage within the NHS'

I heard the idea proposed on the radio a few days ago and thought at the time that it had legs

[Kundry]

I hear a lot of people when complaining about the NHS say 'I pay my taxes' - itemized bills might help as there are many many people who are never going to pay enough tax in their lifetimes to cover their NHS expenses. This is why we need the NHS, to support those who couldn't afford it, but it's also why we need to be careful not to abuse it. We'll miss it when it isn't there anymore.

[CheerfulYank]

I know it happens in the US, I guess, but I've lived here all my life and never been asked for a credit card number, even when I had no insurance. I did get a bill later, but I was never denied treatment for not having insurance and I've never known anyone personally who was.

[littlemonkeyface]

I have no experience of the American health care system but am always surprised how much the English praise the NHS and believe it to be the envy of the world. Sorry, but it is not compared to other European social health care systems (of which I do have experience) where access to doctors, diagnostic procedures and medications is vastly superior.

[PigletJohn]

The story "NHS is the envy of the world" gets pushed by politicians occasionally, I think to discourage voters from saying it should be better, or else to discourage taxpayer from moaning about the cost.

Almost all of Europe has comparable schemes, they vary.

[SurfsUp1]

SconeRhymesWithGone I know my DH's cousin was in hospital for 4 nights after her natural birth in the US. Maybe she just had a really nice hospital or extremely good insurance? She was certainly lead to believe that they did not expect to discharge her earlier.

Here in Aus I know a few people who stayed in hospital for a few extra nights after natural births because they were struggling with feeding.
I guess, like in most places, it's rather a case of luck?

[SconeRhymesWithGone]

SurfsUp Insurance is not supposed to pay for anything that is not medically indicated. The type of insurance should not make a difference in how long someone stays after childbirth; it is the medical condition of the woman that guides the length of stay. Insurance companies don't like to pay; they normally will not pay unless doctors say it's medically necessary.

Was it some years ago? Times used to be longer, but now it's not unheard to stay more than 2 days unless there are complications.

[4321PipandEstella]

YANBU. I live in the US; my husband is American. My insurance is ok, but I do avoid visiting the doctor, as it's $25 a visit, and each inhaler is $25, so it soon adds up. But recently my husband's employer stopped providing health insurance. My husband now has been told he must pay nearly ten times what he was previously paying for new insurance through a different provider. We simply can't afford it, so we will not be able to get him insurance, and will choose instead to pay the fine for not having insurance. The fine is far less than what we'd pay in insurance. How sad is that? We keep thinking there must be another way, but there isn't. When our rental lease expires, we will move to a cheaper property so that we can afford insurance for him for next year. It's all very worrying. We plan on returning to the UK soon.

[SconeRhymesWithGone]

4321PipandEstella Can you not put him on your insurance?